Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $323.59 / $851.14	Facility		$87.10	$323.59	$851.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $208.93 / $302.00 / $407.38	Facility	TC	$208.93	$302.00	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $169.82	Professional		$36.31	$54.95	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.38 / $53.70	Professional	26	$10.00	$17.38	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $42.66 / $85.11	Professional	TC	$26.92	$42.66	$85.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $66,069.34 / $95,499.26	Facility		$120.23	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $63.10 / $63.10	Professional		$16.98	$63.10	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $56.23 / $154.88	Facility		$40.74	$56.23	$154.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $16.98 / $20.89	Facility	26	$16.98	$16.98	$20.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $46.77 / $57.54	Facility	TC	$46.77	$46.77	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $95.50	Professional		$31.62	$50.12	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.49 / $27.54	Professional	26	$9.55	$15.49	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $37.15 / $69.18	Professional	TC	$22.39	$37.15	$69.18
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $69.18 / $104.71	Facility		$58.88	$69.18	$104.71
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $69.18 / $104.71	Professional		$58.88	$69.18	$104.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $58.88 / $85.11	Facility		$38.90	$58.88	$85.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $16.98 / $20.89	Facility	26	$16.98	$16.98	$20.89
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $46.77 / $57.54	Facility	TC	$46.77	$46.77	$57.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $89.13 / $107.15	Professional		$48.98	$89.13	$107.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.98 / $24.55	Professional	26	$10.23	$16.98	$24.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $42.66 / $66.07	Professional	TC	$25.70	$42.66	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $38.90 / $64.57	Professional		$35.48	$38.90	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.48 / $19.50	Professional	26	$11.22	$11.48	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $26.92 / $45.71	Professional	TC	$23.44	$26.92	$45.71