Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.75 / $26.86 / $113.56	Facility	26	$20.75	$26.86	$113.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $67.84 / $114.30	Professional		$49.83	$67.84	$114.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.75 / $27.21 / $42.15	Professional	26	$20.75	$27.21	$42.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.08 / $39.46 / $66.86	Professional	TC	$29.08	$39.46	$66.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.24 / $36.24 / $102.66	Facility	26	$36.24	$36.24	$102.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.04 / $90.12 / $184.97	Professional		$51.04	$90.12	$184.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.16 / $36.39 / $72.54	Professional	26	$22.16	$36.39	$72.54
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.81 / $126.81 / $126.81	Professional	50	$126.81	$126.81	$126.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.89 / $56.05 / $122.50	Professional	TC	$28.89	$56.05	$122.50
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $36.78 / $36.78 / $36.78	Facility	26	$36.78	$36.78	$36.78
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $93.33 / $125.27	Professional		$48.52	$93.33	$125.27
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $35.64 / $48.28	Professional	26	$21.37	$35.64	$48.28
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $27.15 / $59.89 / $81.34	Professional	TC	$27.15	$59.89	$81.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $51.09 / $134.20	Professional		$29.64	$51.09	$134.20
United Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $80.63 / $147.13	Professional		$66.73	$80.63	$147.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.77 / $29.76 / $54.36	Professional	26	$25.77	$29.76	$54.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.72 / $49.77 / $90.43	Professional	TC	$40.72	$49.77	$90.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.58 / $56.58 / $56.58	Professional		$56.58	$56.58	$56.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.89 / $23.89 / $23.89	Professional	26	$23.89	$23.89	$23.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.69 / $32.69 / $32.69	Professional	TC	$32.69	$32.69	$32.69