Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $501.19 / $676.08	Facility		$107.15	$501.19	$676.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $295.12 / $302.00 / $660.69	Facility	TC	$295.12	$302.00	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $537.03	Professional		$89.13	$151.36	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $48.98 / $131.83	Professional	26	$30.90	$48.98	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $100.00 / $208.93	Professional	TC	$61.66	$100.00	$208.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $66,069.34 / $95,499.26	Facility		$302.00	$66,069.34	$95,499.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $169.82 / $169.82	Professional		$54.95	$169.82	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $158.49 / $446.68	Facility		$117.49	$158.49	$446.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $67.61	Facility	26	$54.95	$54.95	$67.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $117.49 / $117.49 / $144.54	Facility	TC	$117.49	$117.49	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $257.04	Professional		$117.49	$169.82	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $54.95 / $81.28	Professional	26	$36.31	$54.95	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $117.49 / $173.78	Professional	TC	$81.28	$117.49	$173.78
MountainHealth Co-op Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $190.55 / $263.03	Facility		$186.21	$190.55	$263.03
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $190.55 / $263.03	Professional		$186.21	$190.55	$263.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $177.83 / $257.04	Facility		$109.65	$177.83	$257.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $67.61	Facility	26	$54.95	$54.95	$67.61
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $117.49 / $117.49 / $144.54	Facility	TC	$117.49	$117.49	$144.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $269.15	Professional		$134.90	$186.21	$269.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $54.95 / $72.44	Professional	26	$36.31	$54.95	$72.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $117.49 / $165.96	Professional	TC	$81.28	$117.49	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $204.17	Professional		$114.82	$128.82	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $38.02 / $63.10	Professional	26	$37.15	$38.02	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $91.20 / $138.04	Professional	TC	$77.62	$91.20	$138.04