Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.74 / $588.60 / $986.03	Facility		$106.74	$588.60	$986.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.89 / $19.80 / $32.67	Facility	26	$17.89	$19.80	$32.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $78.00 / $332.69 / $585.70	Facility	TC	$78.00	$332.69	$585.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.94 / $123.44 / $344.10	Professional		$91.94	$123.44	$344.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.01 / $23.55 / $80.84	Professional	26	$19.01	$23.55	$80.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.34 / $101.95 / $176.39	Professional	TC	$77.34	$101.95	$176.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.54 / $92.44 / $147.63	Professional		$76.54	$92.44	$147.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.31 / $19.54 / $43.45	Professional	26	$15.31	$19.54	$43.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $69.83 / $69.83 / $71.40	Professional	TC	$69.83	$69.83	$71.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.08 / $228.61 / $754.00	Facility		$116.08	$228.61	$754.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.98 / $23.98 / $65.92	Facility	26	$23.98	$23.98	$65.92
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $109.98 / $109.98 / $276.76	Facility	TC	$109.98	$109.98	$276.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.05 / $163.97 / $291.47	Professional		$97.05	$163.97	$291.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.51 / $29.90 / $50.84	Professional	26	$19.51	$29.90	$50.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.29 / $140.41 / $251.65	Professional	TC	$88.29	$140.41	$251.65
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $141.41 / $397.32 / $636.83	Facility		$141.41	$397.32	$636.83
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $23.54 / $23.54 / $23.54	Facility	26	$23.54	$23.54	$23.54
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $101.76 / $101.76 / $101.76	Facility	TC	$101.76	$101.76	$101.76
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $76.55 / $132.74 / $179.38	Professional		$76.55	$132.74	$179.38
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $14.17 / $23.90 / $30.89	Professional	26	$14.17	$23.90	$30.89
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $62.39 / $110.66 / $146.28	Professional	TC	$62.39	$110.66	$146.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.30 / $108.54 / $178.94	Professional		$72.30	$108.54	$178.94
United Facility/Professional Professional Modifier Low / Median / High Price $94.61 / $152.04 / $256.82	Professional		$94.61	$152.04	$256.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.44 / $25.63 / $49.00	Professional	26	$17.44	$25.63	$49.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.65 / $125.13 / $225.05	Professional	TC	$78.65	$125.13	$225.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $90.38 / $90.38 / $90.38	Professional		$90.38	$90.38	$90.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.83 / $15.83 / $15.83	Professional	26	$15.83	$15.83	$15.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $74.55 / $74.55 / $94.76	Professional	TC	$74.55	$74.55	$94.76