Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.00 / $61.40 / $99.25	Facility	26	$60.00	$61.40	$99.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.35 / $302.89 / $419.58	Professional		$214.35	$302.89	$419.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.00 / $61.59 / $123.01	Professional	26	$58.00	$61.59	$123.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.76 / $240.00 / $326.12	Professional	TC	$152.76	$240.00	$326.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.76 / $183.76 / $183.76	Professional		$183.76	$183.76	$183.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.36 / $55.16 / $109.20	Professional	26	$43.36	$55.16	$109.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.64 / $336.84 / $517.04	Professional		$269.64	$336.84	$517.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.13 / $95.75 / $125.79	Professional	26	$69.13	$95.75	$125.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $200.51 / $239.68 / $391.25	Professional	TC	$200.51	$239.68	$391.25
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $53.79 / $56.77 / $184.36	Professional	26	$53.79	$56.77	$184.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.64 / $240.60 / $494.38	Professional		$122.64	$240.60	$494.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $71.70 / $120.22	Professional	26	$38.61	$71.70	$120.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.03 / $165.59 / $391.41	Professional	TC	$84.03	$165.59	$391.41
United Facility/Professional Professional Modifier Low / Median / High Price $201.06 / $271.27 / $512.23	Professional		$201.06	$271.27	$512.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.99 / $72.81 / $116.77	Professional	26	$53.99	$72.81	$116.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.51 / $190.09 / $459.63	Professional	TC	$140.51	$190.09	$459.63