Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $263.03	Professional		$57.54	$85.11	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $23.99 / $85.11	Professional	26	$14.13	$23.99	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $60.26 / $131.83	Professional	TC	$44.67	$60.26	$131.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $112.20 / $112.20	Professional		$23.44	$112.20	$112.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $29.51	Facility	26	$23.44	$23.44	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $165.96	Professional		$50.12	$85.11	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.42 / $39.81	Professional	26	$12.88	$20.42	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $64.57 / $131.83	Professional	TC	$39.81	$64.57	$131.83
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $123.03 / $181.97	Professional		$100.00	$123.03	$181.97
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $29.51	Facility	26	$23.44	$23.44	$29.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $154.88 / $190.55	Professional		$81.28	$154.88	$190.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $23.44 / $34.67	Professional	26	$14.45	$23.44	$34.67
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $79.43 / $125.89	Professional	TC	$46.77	$79.43	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $114.82	Professional		$63.10	$69.18	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.98 / $28.18	Professional	26	$16.60	$16.98	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $52.48 / $87.10	Professional	TC	$45.71	$52.48	$87.10