Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $269.15 / $645.65	Facility		$89.13	$269.15	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $194.98 / $194.98	Facility	26	$194.98	$194.98	$194.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $204.17 / $245.47 / $316.23	Facility	TC	$204.17	$245.47	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $41.69 / $123.03	Professional		$10.47	$41.69	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $14.13 / $63.10	Professional	26	$8.51	$14.13	$63.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.98 / $33.11 / $114.82	Professional	50	$16.98	$33.11	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $39.81 / $95.50	Professional	TC	$20.89	$39.81	$95.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $66,069.34 / $95,499.26	Facility		$107.15	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $54.95 / $54.95	Professional		$14.13	$54.95	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $48.98 / $134.90	Facility		$36.31	$48.98	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $17.38	Facility	26	$14.13	$14.13	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $40.74 / $51.29	Facility	TC	$40.74	$40.74	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $42.66 / $83.18	Professional		$26.92	$42.66	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $22.91	Professional	26	$8.13	$13.18	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.20 / $61.66	Professional	TC	$18.62	$30.20	$61.66
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $60.26 / $91.20	Facility		$47.86	$60.26	$91.20
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $60.26 / $91.20	Professional		$47.86	$60.26	$91.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $50.12 / $72.44	Facility		$33.11	$50.12	$72.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $17.38	Facility	26	$14.13	$14.13	$17.38
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $40.74 / $51.29	Facility	TC	$40.74	$40.74	$51.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $93.33	Professional		$40.74	$77.62	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.13 / $20.89	Professional	26	$8.71	$14.13	$20.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $37.15 / $58.88	Professional	TC	$21.38	$37.15	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $56.23	Professional		$29.51	$33.88	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $9.77 / $16.60	Professional	26	$9.55	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.99 / $39.81	Professional	TC	$19.50	$23.99	$39.81