Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $295.12	Professional		$114.82	$162.18	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $54.95 / $134.90	Professional	26	$38.02	$54.95	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $199.53	Professional	TC	$77.62	$112.20	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $213.80	Professional		$66.07	$66.07	$213.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $66.07 / $79.43	Facility	26	$66.07	$66.07	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $309.03	Professional		$169.82	$213.80	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $61.66 / $100.00	Professional	26	$50.12	$61.66	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $151.36 / $204.17	Professional	TC	$114.82	$151.36	$204.17
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $234.42 / $331.13	Professional		$218.78	$234.42	$331.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $66.07 / $79.43	Facility	26	$66.07	$66.07	$79.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $234.42 / $323.59	Professional		$181.97	$234.42	$323.59
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $95.50	Professional	26	$47.86	$63.10	$95.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $144.54 / $177.83	Professional	TC	$112.20	$144.54	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $229.09 / $275.42	Professional		$186.21	$229.09	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $87.10	Professional	26	$57.54	$74.13	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $158.49 / $186.21	Professional	TC	$125.89	$158.49	$186.21