Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.47 / $2.47 / $3.75	Facility	26	$2.47	$2.47	$3.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.01 / $32.81 / $101.93	Professional		$20.01	$32.81	$101.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.56 / $3.62 / $14.55	Professional	26	$2.56	$3.62	$14.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.68 / $11.94 / $18.60	Professional	52	$9.68	$11.94	$18.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.54 / $25.42 / $51.15	Professional	TC	$17.54	$25.42	$51.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $26.92 / $39.27	Professional		$17.55	$26.92	$39.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.44 / $3.68 / $5.38	Professional	26	$2.44	$3.68	$5.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $9.03	Facility	26	$3.49	$3.49	$9.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $34.90 / $112.53	Professional		$19.23	$34.90	$112.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.90 / $4.57 / $8.11	Professional	26	$2.90	$4.57	$8.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.46 / $31.48 / $103.43	Professional	TC	$18.46	$31.48	$103.43
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $3.25 / $3.25 / $3.25	Facility	26	$3.25	$3.25	$3.25
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $30.61 / $118.05	Professional		$15.77	$30.61	$118.05
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $3.61 / $4.78	Professional	26	$2.00	$3.61	$4.78
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $13.45 / $25.68 / $113.86	Professional	TC	$13.45	$25.68	$113.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.56 / $34.88 / $58.93	Professional		$16.56	$34.88	$58.93
United Facility/Professional Professional Modifier Low / Median / High Price $20.26 / $34.84 / $96.42	Professional		$20.26	$34.84	$96.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.63 / $3.90 / $6.71	Professional	26	$2.63	$3.90	$6.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.54 / $29.10 / $86.34	Professional	TC	$17.54	$29.10	$86.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.36 / $17.36 / $17.36	Professional		$17.36	$17.36	$17.36
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 $15.06 / $15.06 / $19.05	Professional	TC	$15.06	$15.06	$19.05