Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $218.78	Professional		$74.13	$97.72	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.20 / $87.10	Professional	26	$21.88	$30.20	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $66.07 / $165.96	Professional	TC	$47.86	$66.07	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $107.15 / $269.15	Professional		$54.95	$107.15	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $31.62 / $77.62	Professional	26	$16.60	$31.62	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $69.18 / $181.97	Professional	TC	$37.15	$69.18	$181.97
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $194.98 / $426.58	Professional		$117.49	$194.98	$426.58
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $58.88 / $117.49	Professional	26	$30.90	$58.88	$117.49
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $128.82 / $309.03	Professional	TC	$70.79	$128.82	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $104.71 / $323.59	Professional		$52.48	$104.71	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $30.90 / $97.72	Professional	26	$16.22	$30.90	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $70.79 / $208.93	Professional	TC	$36.31	$70.79	$208.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $83.18 / $83.18	Professional		$37.15	$83.18	$83.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $24.55 / $24.55	Professional	26	$10.96	$24.55	$24.55
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $58.88 / $58.88	Professional	TC	$26.30	$58.88	$58.88