Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.08 / $57.37 / $65.69	Facility	26	$49.08	$57.37	$65.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $358.47 / $415.39 / $583.00	Professional		$358.47	$415.39	$583.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $62.23 / $83.66	Professional	26	$53.19	$62.23	$83.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $179.03 / $206.04 / $290.18	Professional	52	$179.03	$206.04	$290.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $300.74 / $349.84 / $511.35	Professional	TC	$300.74	$349.84	$511.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.31 / $67.31 / $67.31	Facility	26	$67.31	$67.31	$67.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.65 / $571.25 / $1,013.58	Professional		$335.65	$571.25	$1,013.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.31 / $85.69 / $149.37	Professional	26	$51.31	$85.69	$149.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.02 / $485.63 / $887.89	Professional	TC	$285.02	$485.63	$887.89
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $268.00 / $325.42 / $497.45	Professional		$268.00	$325.42	$497.45
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $39.04 / $46.61 / $89.90	Professional	26	$39.04	$46.61	$89.90
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $228.96 / $278.47 / $395.08	Professional	TC	$228.96	$278.47	$395.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.73 / $386.88 / $596.64	Professional		$41.73	$386.88	$596.64
United Facility/Professional Professional Modifier Low / Median / High Price $323.89 / $487.35 / $850.67	Professional		$323.89	$487.35	$850.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.37 / $74.45 / $126.06	Professional	26	$47.37	$74.45	$126.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $272.72 / $414.54 / $699.61	Professional	TC	$272.72	$414.54	$699.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $342.87 / $342.87 / $382.85	Professional		$342.87	$342.87	$382.85
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $47.76 / $47.76 / $55.77	Professional	26	$47.76	$47.76	$55.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $295.11 / $295.11 / $327.08	Professional	TC	$295.11	$295.11	$327.08