Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Facility	26	$89.13	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $89.13 / $239.88	Professional		$52.48	$89.13	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $45.71 / $107.15	Professional	26	$23.44	$45.71	$107.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.67 / $57.54 / $446.68	Professional	52	$44.67	$57.54	$446.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $54.95 / $97.72	Professional	TC	$26.92	$54.95	$97.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $89.13 / $89.13	Professional		$41.69	$89.13	$89.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $52.48	Facility	26	$41.69	$41.69	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $181.97	Professional		$79.43	$97.72	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $40.74 / $63.10	Professional	26	$26.30	$40.74	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $63.10 / $128.82	Professional	TC	$47.86	$63.10	$128.82
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $100.00 / $213.80	Professional		$97.72	$100.00	$213.80
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $52.48	Facility	26	$41.69	$41.69	$52.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $144.54	Professional		$85.11	$107.15	$144.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $41.69 / $53.70	Professional	26	$28.84	$41.69	$53.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $50.12 / $100.00	Professional	TC	$41.69	$50.12	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $89.13 / $141.25	Professional		$81.28	$89.13	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $29.51 / $50.12	Professional	26	$27.54	$29.51	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $61.66 / $91.20	Professional	TC	$51.29	$61.66	$91.20