Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $204.17 / $354.81 / $630.96	Facility	TC	$204.17	$354.81	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $57.54 / $199.53	Professional		$20.89	$57.54	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $20.42 / $77.62	Professional	26	$10.47	$20.42	$77.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.89 / $114.82 / $416.87	Professional	50	$20.89	$114.82	$416.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $56.23 / $104.71	Professional	TC	$28.84	$56.23	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $74.13 / $74.13	Professional		$17.38	$74.13	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $17.38 / $21.38	Facility	26	$17.38	$17.38	$21.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $57.54 / $57.54 / $70.79	Facility	TC	$57.54	$57.54	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $56.23 / $112.20	Professional		$36.31	$56.23	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $16.22 / $27.54	Professional	26	$9.77	$16.22	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $41.69 / $85.11	Professional	TC	$25.70	$41.69	$85.11
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $123.03	Professional		$66.07	$81.28	$123.03
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $17.38 / $21.38	Facility	26	$17.38	$17.38	$21.38
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $57.54 / $57.54 / $70.79	Facility	TC	$57.54	$57.54	$70.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $104.71 / $123.03	Professional		$54.95	$104.71	$123.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $17.38 / $25.12	Professional	26	$10.47	$17.38	$25.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $51.29 / $83.18	Professional	TC	$25.70	$51.29	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $44.67 / $75.86	Professional		$39.81	$44.67	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.48 / $19.50	Professional	26	$11.22	$11.48	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.11 / $54.95	Professional	TC	$28.18	$33.11	$54.95