Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $141.25 / $331.13	Facility		$43.65	$141.25	$331.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $13.80 / $17.78	Facility	26	$12.59	$13.80	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $34.67 / $120.23	Facility	TC	$30.20	$34.67	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $85.11	Professional		$32.36	$47.86	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $34.67	Professional	26	$8.71	$12.88	$34.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $186.21 / $204.17	Professional	50	$50.12	$186.21	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	52	$17.78	$17.78	$17.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $56.23	Professional	TC	$21.88	$30.90	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $37.15	Professional		$25.12	$30.90	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.32 / $13.49	Professional	26	$7.41	$8.32	$13.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $32.36	Professional	TC	$19.05	$28.84	$32.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $123.03 / $269.15	Facility		$52.48	$123.03	$269.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $61.66	Professional		$42.66	$50.12	$61.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $14.13 / $18.62	Professional	26	$11.75	$14.13	$18.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $36.31 / $42.66	Professional	TC	$30.90	$36.31	$42.66
Christus Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $40.74 / $112.20	Facility		$38.02	$40.74	$112.20
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $29.51 / $39.81	Facility	TC	$28.18	$29.51	$39.81
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $24.55 / $24.55	Professional	26	$10.47	$24.55	$24.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $95.50 / $128.82	Facility		$53.70	$95.50	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.02 / $72.44	Professional		$26.30	$38.02	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.75 / $20.89	Professional	26	$7.59	$11.75	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $53.70	Professional	TC	$19.05	$28.18	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $173.78 / $251.19	Facility		$77.62	$173.78	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $39.81 / $63.10	Professional		$28.84	$39.81	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $11.48 / $17.78	Professional	26	$9.12	$11.48	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $27.54 / $43.65	Professional	TC	$20.42	$27.54	$43.65