Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $269.15	Professional		$100.00	$131.83	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.18 / $57.54	Professional	26	$22.91	$28.18	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $104.71 / $213.80	Professional	TC	$75.86	$104.71	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $204.17	Professional		$44.67	$44.67	$204.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $54.95	Facility	26	$44.67	$44.67	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $147.91 / $309.03	Professional		$93.33	$147.91	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $38.90 / $70.79	Professional	26	$23.44	$38.90	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $107.15 / $239.88	Professional	TC	$67.61	$107.15	$239.88
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $338.84	Professional		$169.82	$223.87	$338.84
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $54.95	Facility	26	$44.67	$44.67	$54.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $295.12 / $371.54	Professional		$151.36	$295.12	$371.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $44.67 / $63.10	Professional	26	$26.92	$44.67	$63.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $154.88 / $223.87	Professional	TC	$75.86	$154.88	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $213.80	Professional		$95.50	$125.89	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $30.20 / $51.29	Professional	26	$28.18	$30.20	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $95.50 / $158.49	Professional	TC	$66.07	$95.50	$158.49