Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $173.78 / $354.81	Facility	26	$144.54	$173.78	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $741.31 / $1,412.54	Professional		$575.44	$741.31	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $151.36 / $302.00	Professional	26	$114.82	$151.36	$302.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $257.04 / $1,258.93	Professional	52	$181.97	$257.04	$1,258.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $562.34 / $870.96	Professional	TC	$457.09	$562.34	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $616.60 / $812.83	Professional		$549.54	$616.60	$812.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $125.89 / $158.49	Professional	26	$107.15	$125.89	$158.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $467.74 / $575.44	Professional	TC	$323.59	$467.74	$575.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $741.31 / $812.83	Professional		$616.60	$741.31	$812.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $144.54 / $158.49	Professional	26	$123.03	$144.54	$158.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $602.56 / $660.69	Professional	TC	$501.19	$602.56	$660.69
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $125.89 / $125.89	Professional	26	$39.81	$125.89	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $812.83 / $1,288.25	Professional		$588.84	$812.83	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $162.18 / $251.19	Professional	26	$117.49	$162.18	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $645.65 / $1,000.00	Professional	TC	$457.09	$645.65	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $707.95 / $1,230.27	Professional		$537.03	$707.95	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $239.88	Professional	26	$107.15	$141.25	$239.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $562.34 / $933.25	Professional	TC	$426.58	$562.34	$933.25