Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $169.82	Professional		$64.57	$89.13	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $46.77 / $85.11	Professional	26	$39.81	$46.77	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.02 / $70.79	Professional	TC	$21.88	$38.02	$70.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $125.89	Professional		$63.10	$63.10	$125.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $75.86	Facility	26	$63.10	$63.10	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $281.84	Professional		$72.44	$112.20	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $63.10 / $144.54	Professional	26	$44.67	$63.10	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $48.98 / $138.04	Professional	TC	$22.91	$48.98	$138.04
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $141.25	Professional		$104.71	$134.90	$141.25
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $75.86	Facility	26	$63.10	$63.10	$75.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $199.53	Professional		$79.43	$120.23	$199.53
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $60.26 / $89.13	Professional	26	$42.66	$60.26	$89.13
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $74.13	Professional	TC	$23.99	$44.67	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $144.54	Professional		$97.72	$117.49	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $85.11	Professional	26	$57.54	$70.79	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $46.77 / $61.66	Professional	TC	$32.36	$46.77	$61.66