Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $25.15 / $98.97	Facility	26	$19.60	$25.15	$98.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.71 / $60.85 / $101.52	Professional		$42.71	$60.85	$101.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $26.28 / $38.10	Professional	26	$19.60	$26.28	$38.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.36 / $28.56 / $38.29	Professional	52	$21.36	$28.56	$38.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.11 / $34.90 / $60.00	Professional	TC	$23.11	$34.90	$60.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $89.56	Facility	26	$33.84	$33.84	$89.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $73.48 / $143.19	Professional		$45.83	$73.48	$143.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.73 / $32.02 / $62.02	Professional	26	$20.73	$32.02	$62.02
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.56 / $85.56 / $85.56	Professional	50	$85.56	$85.56	$85.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.09 / $42.91 / $84.04	Professional	TC	$25.09	$42.91	$84.04
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $32.47 / $32.47 / $32.47	Facility	26	$32.47	$32.47	$32.47
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $78.93 / $110.72	Professional		$44.39	$78.93	$110.72
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.01 / $30.44 / $42.62	Professional	26	$20.01	$30.44	$42.62
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $24.38 / $48.33 / $69.73	Professional	TC	$24.38	$48.33	$69.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $48.83 / $90.47	Professional		$28.86	$48.83	$90.47
United Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $64.37 / $115.39	Professional		$52.45	$64.37	$115.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $25.70 / $45.20	Professional	26	$22.04	$25.70	$45.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.44 / $38.79 / $67.69	Professional	TC	$27.44	$38.79	$67.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $44.39 / $44.39	Professional		$44.39	$44.39	$44.39
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.36 / $19.36 / $19.36	Professional	26	$19.36	$19.36	$19.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.02 / $25.02 / $25.02	Professional	TC	$25.02	$25.02	$25.02