Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $338.84	Facility	26	$67.61	$67.61	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $338.84 / $630.96	Professional		$239.88	$338.84	$630.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $114.82 / $162.18	Facility	26	$24.55	$114.82	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $794.33	Professional		$251.19	$426.58	$794.33
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	26	$112.20	$112.20	$112.20
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $575.44	Professional		$229.09	$371.54	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $158.49 / $457.09	Professional		$32.36	$158.49	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $489.78 / $954.99	Professional		$302.00	$489.78	$954.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $323.59	Professional		$263.03	$263.03	$323.59