Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Facility	26	$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $97.72	Professional		$46.77	$54.95	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.95 / $38.02	Professional	26	$13.80	$19.95	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $34.67 / $56.23	Professional	TC	$30.90	$34.67	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $56.23 / $109.65	Professional		$30.90	$56.23	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.89 / $40.74	Professional	26	$10.96	$20.89	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $35.48 / $69.18	Professional	TC	$20.42	$35.48	$69.18
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $100.00	Professional		$43.65	$64.57	$100.00
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $23.44 / $36.31	Professional	26	$15.14	$23.44	$36.31
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $42.66 / $64.57	Professional	TC	$28.84	$42.66	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.11 / $44.67	Professional		$24.55	$33.11	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $158.49	Professional		$33.88	$45.71	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.60 / $57.54	Professional	26	$12.02	$16.60	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.18 / $102.33	Professional	TC	$21.38	$28.18	$102.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $38.90 / $38.90	Professional		$17.38	$38.90	$38.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $14.45 / $14.45	Professional	26	$6.46	$14.45	$14.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $24.55 / $24.55	Professional	TC	$10.96	$24.55	$24.55