Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.17 / $90.87 / $95.95	Facility	26	$85.17	$90.87	$95.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.99 / $343.68 / $703.78	Professional		$237.99	$343.68	$703.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.87 / $102.50 / $175.19	Professional	26	$90.87	$102.50	$175.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $150.02 / $150.02 / $150.02	Professional	52	$150.02	$150.02	$150.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.13 / $229.43 / $363.21	Professional	TC	$147.13	$229.43	$363.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.83 / $420.56 / $668.15	Professional		$287.83	$420.56	$668.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.23 / $143.47 / $222.55	Professional	26	$87.23	$143.47	$222.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.59 / $283.24 / $454.28	Professional	TC	$201.59	$283.24	$454.28
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $208.08 / $237.32 / $417.43	Professional		$208.08	$237.32	$417.43
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $70.14 / $75.15 / $132.19	Professional	26	$70.14	$75.15	$132.19
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $129.21 / $162.16 / $285.24	Professional	TC	$129.21	$162.16	$285.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.91 / $247.10 / $425.67	Professional		$97.91	$247.10	$425.67
United Facility/Professional Professional Modifier Low / Median / High Price $258.39 / $383.90 / $673.92	Professional		$258.39	$383.90	$673.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.19 / $126.67 / $209.43	Professional	26	$87.19	$126.67	$209.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.31 / $254.01 / $478.42	Professional	TC	$171.31	$254.01	$478.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $259.41 / $259.41 / $259.41	Professional		$259.41	$259.41	$259.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $78.13 / $78.13 / $103.41	Professional	26	$78.13	$78.13	$103.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $181.28 / $181.28 / $229.70	Professional	TC	$181.28	$181.28	$229.70