Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.57 / $92.50 / $98.34	Facility	26	$87.57	$92.50	$98.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.76 / $277.13 / $426.99	Professional		$238.76	$277.13	$426.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.19 / $98.34 / $126.30	Professional	26	$89.19	$98.34	$126.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.26 / $178.79 / $297.63	Professional	TC	$146.26	$178.79	$297.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.02 / $425.69 / $669.50	Professional		$292.02	$425.69	$669.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.73 / $147.66 / $230.68	Professional	26	$89.73	$147.66	$230.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.98 / $281.16 / $442.62	Professional	TC	$199.98	$281.16	$442.62
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $210.03 / $238.97 / $420.33	Professional		$210.03	$238.97	$420.33
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $72.11 / $77.26 / $135.90	Professional	26	$72.11	$77.26	$135.90
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $128.96 / $161.71 / $284.44	Professional	TC	$128.96	$161.71	$284.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.95 / $247.10 / $423.01	Professional		$97.95	$247.10	$423.01
United Facility/Professional Professional Modifier Low / Median / High Price $261.75 / $370.06 / $656.48	Professional		$261.75	$370.06	$656.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.73 / $133.00 / $214.82	Professional	26	$91.73	$133.00	$214.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.72 / $248.75 / $461.15	Professional	TC	$162.72	$248.75	$461.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $260.69 / $260.69 / $260.69	Professional		$260.69	$260.69	$260.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $79.92 / $79.92 / $106.67	Professional	26	$79.92	$79.92	$106.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $180.77 / $180.77 / $229.05	Professional	TC	$180.77	$180.77	$229.05