Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $95.50	Professional		$41.69	$57.54	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $29.51	Professional	26	$12.02	$15.85	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $40.74 / $57.54	Professional	TC	$30.20	$40.74	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $21.88 / $26.30	Facility	26	$21.88	$21.88	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $69.18 / $147.91	Professional		$57.54	$69.18	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $47.86	Professional	26	$15.85	$21.88	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $47.86 / $100.00	Professional	TC	$39.81	$47.86	$100.00
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $107.15	Professional		$72.44	$77.62	$107.15
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $21.88 / $26.30	Facility	26	$21.88	$21.88	$26.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $112.20	Professional		$57.54	$75.86	$112.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $21.38 / $31.62	Professional	26	$15.14	$21.38	$31.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $47.86 / $63.10	Professional	TC	$34.67	$47.86	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $100.00	Professional		$69.18	$87.10	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.12 / $30.20	Professional	26	$20.42	$25.12	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $60.26 / $70.79	Professional	TC	$47.86	$60.26	$70.79