Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $245.47 / $645.65	Facility		$123.03	$245.47	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Facility	26	$27.54	$27.54	$27.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $204.17 / $316.23 / $398.11	Facility	TC	$204.17	$316.23	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $32.36 / $120.23	Professional		$24.55	$32.36	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $40.74	Professional	26	$7.94	$10.96	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.39 / $56.23	Professional	TC	$15.85	$22.39	$56.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $66,069.34 / $95,499.26	Facility		$81.28	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $44.67 / $44.67	Professional		$13.18	$44.67	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $40.74 / $114.82	Facility		$30.20	$40.74	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $16.22	Facility	26	$13.18	$13.18	$16.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $30.90 / $38.02	Facility	TC	$30.90	$30.90	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $36.31 / $75.86	Professional		$22.91	$36.31	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.30 / $21.38	Professional	26	$7.59	$12.30	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $25.12 / $53.70	Professional	TC	$15.49	$25.12	$53.70
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $48.98 / $85.11	Facility		$45.71	$48.98	$85.11
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $48.98 / $85.11	Professional		$45.71	$48.98	$85.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $43.65 / $63.10	Facility		$28.18	$43.65	$63.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $16.22	Facility	26	$13.18	$13.18	$16.22
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $30.90 / $38.02	Facility	TC	$30.90	$30.90	$38.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $74.13	Professional		$38.02	$61.66	$74.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $19.05	Professional	26	$8.13	$13.18	$19.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.90 / $45.71	Professional	TC	$18.62	$30.90	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $28.84 / $51.29	Professional		$26.30	$28.84	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.12 / $15.14	Professional	26	$8.91	$9.12	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.95 / $34.67	Professional	TC	$16.98	$19.95	$34.67