Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.38 / $158.96 / $179.47	Facility	26	$148.38	$158.96	$179.47
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $189.68 / $194.76 / $219.89	Facility	53	$189.68	$194.76	$219.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $722.32 / $973.78 / $1,396.27	Professional		$722.32	$973.78	$1,396.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.75 / $173.18 / $228.05	Professional	26	$102.75	$173.18	$228.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $305.72 / $486.89 / $653.21	Professional	52	$305.72	$486.89	$653.21
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $122.29 / $194.76 / $261.27	Professional	53	$122.29	$194.76	$261.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $619.57 / $802.61 / $1,108.33	Professional	TC	$619.57	$802.61	$1,108.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $513.54 / $513.54 / $513.54	Professional		$513.54	$513.54	$513.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $814.24 / $911.95 / $1,432.65	Professional		$814.24	$911.95	$1,432.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $129.68 / $148.25 / $275.00	Professional	26	$129.68	$148.25	$275.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $681.88 / $763.70 / $1,116.20	Professional	TC	$681.88	$763.70	$1,116.20
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $116.06 / $129.02 / $129.02	Professional	26	$116.06	$129.02	$129.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $637.01 / $906.24 / $1,460.49	Professional		$637.01	$906.24	$1,460.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.94 / $147.18 / $272.66	Professional	26	$104.94	$147.18	$272.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $532.05 / $741.64 / $1,200.21	Professional	TC	$532.05	$741.64	$1,200.21
United Facility/Professional Professional Modifier Low / Median / High Price $725.84 / $926.27 / $1,618.80	Professional		$725.84	$926.27	$1,618.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.37 / $176.05 / $273.48	Professional	26	$115.37	$176.05	$273.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $597.92 / $747.41 / $1,302.05	Professional	TC	$597.92	$747.41	$1,302.05