Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	26	$281.84	$281.84	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $478.63 / $1,230.27	Professional		$208.93	$478.63	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $125.89 / $331.13	Professional	26	$69.18	$125.89	$331.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $138.04 / $138.04 / $234.42	Professional	52	$138.04	$138.04	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $257.04 / $562.34	Professional	TC	$131.83	$257.04	$562.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $309.03 / $309.03	Professional		$109.65	$309.03	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $134.90	Facility	26	$109.65	$109.65	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $467.74 / $691.83	Professional		$204.17	$467.74	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $91.20 / $194.98	Professional	26	$48.98	$91.20	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $302.00 / $512.86	Professional	TC	$138.04	$302.00	$512.86
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $346.74 / $724.44	Professional		$338.84	$346.74	$724.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $134.90	Facility	26	$109.65	$109.65	$134.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $467.74 / $575.44	Professional		$288.40	$467.74	$575.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $109.65 / $158.49	Professional	26	$67.61	$109.65	$158.49
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $199.53 / $426.58	Professional	TC	$131.83	$199.53	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $338.84 / $549.54	Professional		$186.21	$338.84	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $70.79 / $128.82	Professional	26	$64.57	$70.79	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $218.78 / $389.05	Professional	TC	$123.03	$218.78	$389.05