Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.67 / $47.67 / $52.62	Facility	26	$47.67	$47.67	$52.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.86 / $155.75 / $237.71	Professional		$128.86	$155.75	$237.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.67 / $56.42 / $76.67	Professional	26	$47.67	$56.42	$76.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.03 / $102.06 / $160.69	Professional	TC	$84.03	$102.06	$160.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.70 / $66.70 / $175.29	Facility	26	$66.70	$66.70	$175.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.10 / $400.57 / $679.98	Professional		$267.10	$400.57	$679.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.64 / $77.95 / $136.40	Professional	26	$52.64	$77.95	$136.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.73 / $329.25 / $551.79	Professional	TC	$215.73	$329.25	$551.79
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $124.17 / $248.34 / $368.28	Professional		$124.17	$248.34	$368.28
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $24.15 / $48.29 / $73.56	Professional	26	$24.15	$48.29	$73.56
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $100.03 / $189.62 / $294.72	Professional	TC	$100.03	$189.62	$294.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $123.17 / $240.02	Professional		$65.56	$123.17	$240.02
United Facility/Professional Professional Modifier Low / Median / High Price $233.36 / $333.73 / $611.91	Professional		$233.36	$333.73	$611.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.95 / $65.92 / $117.25	Professional	26	$44.95	$65.92	$117.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.41 / $271.58 / $478.47	Professional	TC	$188.41	$271.58	$478.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.92 / $223.92 / $223.92	Professional		$223.92	$223.92	$223.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $44.17 / $44.17	Professional	26	$44.17	$44.17	$44.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $106.71 / $179.75 / $179.75	Professional	TC	$106.71	$179.75	$179.75