Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $263.03 / $446.68	Facility		$93.33	$263.03	$446.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $199.53 / $245.47 / $309.03	Facility	TC	$199.53	$245.47	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $44.67 / $138.04	Professional		$11.48	$44.67	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $64.57	Professional	26	$7.94	$14.13	$64.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.85 / $91.20 / $112.20	Professional	50	$15.85	$91.20	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $120.23	Professional	TC	$23.99	$44.67	$120.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $66,069.34 / $95,499.26	Facility		$117.49	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $57.54 / $57.54	Professional		$13.18	$57.54	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $53.70 / $151.36	Facility		$39.81	$53.70	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $16.22	Facility	26	$13.18	$13.18	$16.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.67 / $44.67 / $54.95	Facility	TC	$44.67	$44.67	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $44.67 / $87.10	Professional		$28.84	$44.67	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $12.30 / $21.38	Professional	26	$6.92	$12.30	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $67.61	Professional	TC	$20.89	$33.88	$67.61
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $63.10 / $95.50	Facility		$52.48	$63.10	$95.50
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $95.50	Professional		$52.48	$63.10	$95.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $52.48 / $77.62	Facility		$35.48	$52.48	$77.62
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $16.22	Facility	26	$13.18	$13.18	$16.22
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $44.67 / $44.67 / $54.95	Facility	TC	$44.67	$44.67	$54.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $81.28 / $97.72	Professional		$44.67	$81.28	$97.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $19.05	Professional	26	$8.13	$13.18	$19.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $41.69 / $64.57	Professional	TC	$20.89	$41.69	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $35.48 / $60.26	Professional		$30.90	$35.48	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.12 / $15.14	Professional	26	$8.51	$9.12	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $26.30 / $44.67	Professional	TC	$21.88	$26.30	$44.67