Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $288.40 / $794.33	Professional		$131.83	$288.40	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $147.91 / $616.60	Professional	26	$58.88	$147.91	$616.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $95.50 / $389.05	Professional	TC	$67.61	$95.50	$389.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $199.53	Professional		$95.50	$95.50	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $117.49	Facility	26	$95.50	$95.50	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $199.53 / $302.00	Professional		$104.71	$199.53	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $70.79 / $123.03	Professional	26	$51.29	$70.79	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $125.89 / $177.83	Professional	TC	$53.70	$125.89	$177.83
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $218.78 / $794.33	Professional		$213.80	$218.78	$794.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $117.49	Facility	26	$95.50	$95.50	$117.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $302.00	Professional		$128.82	$194.98	$302.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $138.04	Professional	26	$61.66	$95.50	$138.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $104.71 / $162.18	Professional	TC	$66.07	$104.71	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $234.42	Professional		$162.18	$190.55	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $81.28 / $107.15	Professional	26	$77.62	$81.28	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $112.20 / $138.04	Professional	TC	$85.11	$112.20	$138.04