Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.45 / $16.80 / $491.90	Facility		$15.45	$16.80	$491.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.25 / $2.41 / $2.64	Facility	26	$2.25	$2.41	$2.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.68 / $24.20 / $54.13	Professional		$15.68	$24.20	$54.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.25 / $3.10 / $4.74	Professional	26	$2.25	$3.10	$4.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $7.74 / $10.78 / $15.52	Professional	52	$7.74	$10.78	$15.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.42 / $19.23 / $28.82	Professional	TC	$13.42	$19.23	$28.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $27.72 / $37.65	Professional		$27.72	$27.72	$37.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.41 / $5.41 / $5.41	Professional	26	$5.41	$5.41	$5.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $28.54 / $35.36	Facility		$26.10	$28.54	$35.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $9.41	Facility	26	$3.41	$3.41	$9.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.46 / $31.32 / $61.44	Professional		$17.46	$31.32	$61.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.66 / $4.74 / $13.63	Professional	26	$2.66	$4.74	$13.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.88 / $26.77 / $47.16	Professional	TC	$15.88	$26.77	$47.16
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $7.58 / $14.82 / $22.67	Facility		$7.58	$14.82	$22.67
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $14.99 / $28.06 / $66.31	Professional		$14.99	$28.06	$66.31
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $2.10 / $6.21 / $13.78	Professional	26	$2.10	$6.21	$13.78
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $12.89 / $21.99 / $53.40	Professional	TC	$12.89	$21.99	$53.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.32 / $33.62 / $55.57	Professional		$15.32	$33.62	$55.57
United Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $27.62 / $52.52	Professional		$16.73	$27.62	$52.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.60 / $4.16 / $12.41	Professional	26	$2.60	$4.16	$12.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.61 / $22.83 / $41.26	Professional	TC	$14.61	$22.83	$41.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.62 / $17.62 / $17.62	Professional		$17.62	$17.62	$17.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.29 / $2.29 / $2.29	Professional	26	$2.29	$2.29	$2.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.32 / $15.32 / $19.62	Professional	TC	$15.32	$15.32	$19.62