Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $263.03 / $263.03	Facility	26	$144.54	$263.03	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $426.58 / $1,148.15	Professional		$104.71	$426.58	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $125.89 / $501.19	Professional	26	$63.10	$125.89	$501.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $478.63 / $478.63 / $912.01	Professional	50	$478.63	$478.63	$912.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $338.84 / $724.44	Professional	TC	$154.88	$338.84	$724.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $331.13 / $331.13	Professional		$100.00	$331.13	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $123.03	Facility	26	$100.00	$100.00	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $489.78 / $630.96	Professional		$213.80	$489.78	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $79.43 / $177.83	Professional	26	$44.67	$79.43	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $338.84 / $524.81	Professional	TC	$154.88	$338.84	$524.81
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $371.54 / $758.58	Professional		$354.81	$371.54	$758.58
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $123.03	Facility	26	$100.00	$100.00	$123.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $489.78 / $588.84	Professional		$309.03	$489.78	$588.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $100.00 / $147.91	Professional	26	$63.10	$100.00	$147.91
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $229.09 / $436.52	Professional	TC	$151.36	$229.09	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $354.81 / $575.44	Professional		$199.53	$354.81	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $114.82	Professional	26	$58.88	$58.88	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $251.19 / $407.38	Professional	TC	$138.04	$251.19	$407.38