Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $331.13 / $724.44	Facility		$141.25	$331.13	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $95.50 / $309.03	Professional		$48.98	$95.50	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $63.10 / $144.54	Professional	26	$30.20	$63.10	$144.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $144.54 / $630.96	Professional	50	$56.23	$144.54	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $60.26 / $162.18	Professional	TC	$42.66	$60.26	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $66,069.34 / $95,499.26	Facility		$218.78	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $112.20 / $309.03	Facility		$81.28	$112.20	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $63.10	Facility	26	$50.12	$50.12	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $190.55	Professional		$95.50	$128.82	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $48.98 / $75.86	Professional	26	$37.15	$48.98	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $81.28 / $120.23	Professional	TC	$57.54	$81.28	$120.23
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $147.91 / $186.21	Facility		$144.54	$147.91	$186.21
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $147.91 / $186.21	Professional		$144.54	$147.91	$186.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $125.89 / $199.53	Facility		$81.28	$125.89	$199.53
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $63.10	Facility	26	$50.12	$50.12	$63.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $199.53	Professional		$109.65	$147.91	$199.53
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $50.12 / $67.61	Professional	26	$37.15	$50.12	$67.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $83.18 / $104.71	Professional	TC	$56.23	$83.18	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $151.36	Professional		$89.13	$93.33	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $35.48 / $58.88	Professional	26	$34.67	$35.48	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $54.95 / $91.20	Professional	TC	$54.95	$54.95	$91.20