Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	TC	$446.68	$446.68	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $60.26 / $234.42	Professional		$44.67	$60.26	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.98 / $64.57	Professional	26	$13.18	$16.98	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $46.77 / $109.65	Professional	TC	$32.36	$46.77	$109.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $85.11 / $85.11	Professional		$21.88	$85.11	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $21.88 / $27.54	Facility	26	$21.88	$21.88	$27.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $63.10 / $63.10 / $77.62	Facility	TC	$63.10	$63.10	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $66.07 / $128.82	Professional		$38.90	$66.07	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.62 / $37.15	Professional	26	$12.02	$18.62	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $46.77 / $95.50	Professional	TC	$28.18	$46.77	$95.50
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $141.25	Professional		$77.62	$93.33	$141.25
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $21.88 / $27.54	Facility	26	$21.88	$21.88	$27.54
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $63.10 / $63.10 / $77.62	Facility	TC	$63.10	$63.10	$77.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $120.23 / $144.54	Professional		$64.57	$120.23	$144.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $21.88 / $32.36	Professional	26	$13.49	$21.88	$32.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $57.54 / $91.20	Professional	TC	$34.67	$57.54	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $52.48 / $89.13	Professional		$48.98	$52.48	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.85 / $26.30	Professional	26	$15.14	$15.85	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $37.15 / $63.10	Professional	TC	$33.88	$37.15	$63.10