Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $245.47 / $398.11	Facility		$85.11	$245.47	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $29.51 / $29.51	Facility	26	$29.51	$29.51	$29.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $208.93 / $245.47 / $295.12	Facility	TC	$208.93	$245.47	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $51.29 / $173.78	Professional		$14.79	$51.29	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $15.85 / $60.26	Professional	26	$8.71	$15.85	$60.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $39.81 / $251.19	Professional	50	$19.05	$39.81	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $134.90	Professional	TC	$25.12	$43.65	$134.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $66,069.34 / $95,499.26	Facility		$131.83	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $64.57 / $64.57	Professional		$14.13	$64.57	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $61.66 / $169.82	Facility		$44.67	$61.66	$169.82
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 $50.12 / $50.12 / $63.10	Facility	TC	$50.12	$50.12	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $97.72	Professional		$31.62	$50.12	$97.72
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 $22.91 / $38.02 / $75.86	Professional	TC	$22.91	$38.02	$75.86
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $70.79 / $107.15	Facility		$58.88	$70.79	$107.15
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $70.79 / $107.15	Professional		$58.88	$70.79	$107.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $58.88 / $87.10	Facility		$39.81	$58.88	$87.10
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 $50.12 / $50.12 / $63.10	Facility	TC	$50.12	$50.12	$63.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $91.20 / $109.65	Professional		$50.12	$91.20	$109.65
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 $22.91 / $45.71 / $72.44	Professional	TC	$22.91	$45.71	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $39.81 / $67.61	Professional		$34.67	$39.81	$67.61
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 $24.55 / $30.20 / $50.12	Professional	TC	$24.55	$30.20	$50.12