Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $245.47 / $426.58	Facility		$77.62	$245.47	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $41.69 / $47.86	Facility	26	$37.15	$41.69	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $89.13 / $190.55	Professional		$38.02	$89.13	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $50.12 / $112.20	Professional	26	$28.18	$50.12	$112.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $104.71 / $309.03	Professional	50	$47.86	$104.71	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $56.23 / $97.72	Professional	TC	$39.81	$56.23	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $112.20	Professional		$64.57	$67.61	$112.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $51.29	Professional	26	$24.55	$32.36	$51.29
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $97.72 / $125.89 / $173.78	Professional	50	$97.72	$125.89	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $42.66 / $53.70	Professional	TC	$37.15	$42.66	$53.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $128.82 / $181.97	Facility		$79.43	$128.82	$181.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $141.25	Professional		$89.13	$104.71	$141.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $41.69 / $58.88	Professional	26	$35.48	$41.69	$58.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $83.18	Professional	TC	$53.70	$63.10	$83.18
Christus Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $81.28	Facility		$64.57	$64.57	$81.28
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $33.88 / $33.88	Professional	26	$30.20	$33.88	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $181.97 / $245.47	Facility		$97.72	$181.97	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $162.18	Professional		$57.54	$87.10	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $35.48 / $64.57	Professional	26	$22.91	$35.48	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $50.12 / $95.50	Professional	TC	$33.11	$50.12	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $138.04 / $208.93	Facility		$66.07	$138.04	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $138.04	Professional		$66.07	$89.13	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.88 / $52.48	Professional	26	$25.70	$33.88	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $51.29 / $81.28	Professional	TC	$38.90	$51.29	$81.28