Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.45 / $75.91 / $117.86	Facility	26	$71.45	$75.91	$117.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.60 / $280.58 / $478.67	Professional		$225.60	$280.58	$478.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.68 / $78.79 / $103.69	Professional	26	$74.68	$78.79	$103.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.69 / $180.68 / $272.82	Professional	TC	$149.69	$180.68	$272.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.15 / $388.33 / $598.00	Professional		$246.15	$388.33	$598.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.23 / $115.66 / $175.11	Professional	26	$71.23	$115.66	$175.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.96 / $270.79 / $422.99	Professional	TC	$174.96	$270.79	$422.99
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $181.55 / $194.52 / $342.15	Professional		$181.55	$194.52	$342.15
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $57.44 / $61.55 / $108.25	Professional	26	$57.44	$61.55	$108.25
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $110.50 / $131.87 / $233.90	Professional	TC	$110.50	$131.87	$233.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.91 / $210.88 / $345.08	Professional		$97.91	$210.88	$345.08
United Facility/Professional Professional Modifier Low / Median / High Price $227.16 / $345.03 / $574.82	Professional		$227.16	$345.03	$574.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.04 / $101.67 / $168.98	Professional	26	$69.04	$101.67	$168.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $242.84 / $402.54	Professional	TC	$162.63	$242.84	$402.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $212.43 / $212.43 / $212.43	Professional		$212.43	$212.43	$212.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $63.83 / $63.83 / $84.81	Professional	26	$63.83	$63.83	$84.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $148.60 / $148.60 / $188.38	Professional	TC	$148.60	$148.60	$188.38