Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $302.00 / $371.54	Facility		$257.04	$302.00	$371.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $380.19 / $426.58 / $426.58	Facility	TC	$380.19	$426.58	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $44.67 / $158.49	Professional		$36.31	$44.67	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $47.86	Professional	26	$10.00	$16.22	$47.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $23.44 / $38.02 / $38.02	Professional	50	$23.44	$38.02	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $77.62	Professional	TC	$25.70	$33.11	$77.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $66,069.34 / $95,499.26	Facility		$125.89	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $64.57	Professional		$16.98	$16.98	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $58.88 / $165.96	Facility		$43.65	$58.88	$165.96
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 $47.86 / $47.86 / $60.26	Facility	TC	$47.86	$47.86	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $51.29 / $97.72	Professional		$31.62	$51.29	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.13 / $27.54	Professional	26	$9.12	$14.13	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $37.15 / $72.44	Professional	TC	$22.39	$37.15	$72.44
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $72.44 / $107.15	Facility		$63.10	$72.44	$107.15
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $72.44 / $107.15	Professional		$63.10	$72.44	$107.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $58.88 / $89.13	Facility		$38.02	$58.88	$89.13
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 $47.86 / $47.86 / $60.26	Facility	TC	$47.86	$47.86	$60.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $91.20 / $109.65	Professional		$51.29	$91.20	$109.65
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 $28.18 / $44.67 / $70.79	Professional	TC	$28.18	$44.67	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $40.74 / $67.61	Professional		$39.81	$40.74	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.30 / $19.95	Professional	26	$11.48	$12.30	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.84 / $48.98	Professional	TC	$28.18	$28.84	$48.98