Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $257.04 / $933.25	Professional		$154.88	$257.04	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $204.17	Professional	26	$58.88	$85.11	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $154.88 / $302.00	Professional	TC	$95.50	$154.88	$302.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $239.88	Professional		$95.50	$95.50	$239.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $117.49	Facility	26	$95.50	$95.50	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $467.74	Professional		$173.78	$281.84	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $72.44 / $169.82	Professional	26	$42.66	$72.44	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $204.17 / $288.40	Professional	TC	$117.49	$204.17	$288.40
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $275.42 / $398.11	Professional		$263.03	$275.42	$398.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $117.49	Facility	26	$95.50	$95.50	$117.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $436.52	Professional		$218.78	$346.74	$436.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $95.50 / $138.04	Professional	26	$58.88	$95.50	$138.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $154.88 / $223.87	Professional	TC	$97.72	$154.88	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $218.78 / $309.03	Professional		$141.25	$218.78	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $109.65	Professional	26	$56.23	$56.23	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $154.88 / $223.87	Professional	TC	$87.10	$154.88	$223.87