Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.02 / $140.57 / $625.62	Facility		$95.02	$140.57	$625.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.79 / $45.42 / $58.74	Facility	26	$39.79	$45.42	$58.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $80.27 / $176.32 / $419.33	Facility	TC	$80.27	$176.32	$419.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.88 / $129.11 / $190.18	Professional		$91.88	$129.11	$190.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $42.83 / $71.79	Professional	26	$30.35	$42.83	$71.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.94 / $61.93 / $67.70	Professional	52	$37.94	$61.93	$67.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.70 / $84.06 / $126.39	Professional	TC	$62.70	$84.06	$126.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.92 / $99.67 / $114.11	Professional		$73.92	$99.67	$114.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.10 / $34.65 / $54.57	Professional	26	$32.10	$34.65	$54.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.09 / $194.33 / $276.48	Facility		$118.09	$194.33	$276.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.57 / $132.85 / $207.79	Professional		$119.57	$132.85	$207.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.79 / $45.32 / $67.69	Professional	26	$40.79	$45.32	$67.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.40 / $87.53 / $153.83	Professional	TC	$74.40	$87.53	$153.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.29 / $94.28 / $104.47	Facility		$79.29	$94.28	$104.47
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $62.47 / $62.47 / $69.09	Facility	TC	$62.47	$62.47	$69.09
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $31.80 / $35.56 / $36.57	Professional	26	$31.80	$35.56	$36.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.83 / $206.75 / $336.32	Facility		$137.83	$206.75	$336.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.24 / $110.52 / $190.87	Professional		$63.24	$110.52	$190.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.69 / $37.64 / $64.09	Professional	26	$21.69	$37.64	$64.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.55 / $70.95 / $126.17	Professional	TC	$41.55	$70.95	$126.17
United Facility/Professional Facility Modifier Low / Median / High Price $245.18 / $245.18 / $245.18	Facility		$245.18	$245.18	$245.18
United Facility/Professional Professional Modifier Low / Median / High Price $86.35 / $115.72 / $199.10	Professional		$86.35	$115.72	$199.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.90 / $37.53 / $56.70	Professional	26	$26.90	$37.53	$56.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.97 / $75.27 / $132.86	Professional	TC	$54.97	$75.27	$132.86