Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $2,511.89	Professional		$1,071.52	$1,412.54	$2,511.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $288.40 / $363.08 / $1,318.26	Professional	26	$288.40	$363.08	$1,318.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $776.25 / $933.25 / $1,479.11	Professional	TC	$776.25	$933.25	$1,479.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $1,621.81 / $1,621.81	Professional		$446.68	$1,621.81	$1,621.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $537.03	Facility	26	$446.68	$446.68	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $2,398.83	Professional		$1,148.15	$1,621.81	$2,398.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $346.74 / $446.68 / $691.83	Professional	26	$346.74	$446.68	$691.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $1,174.90 / $1,737.80	Professional	TC	$794.33	$1,174.90	$1,737.80
MountainHealth Co-op Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,819.70 / $2,137.96	Professional		$1,737.80	$1,819.70	$2,137.96
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $537.03	Facility	26	$446.68	$446.68	$537.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,548.82 / $2,290.87	Professional		$1,122.02	$1,548.82	$2,290.87
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $416.87 / $660.69	Professional	26	$302.00	$416.87	$660.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $1,148.15 / $1,659.59	Professional	TC	$794.33	$1,148.15	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,778.28 / $1,995.26	Professional		$1,584.89	$1,778.28	$1,995.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $446.68 / $512.86 / $602.56	Professional	26	$446.68	$512.86	$602.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.48 / $1,258.93 / $1,412.54	Professional	TC	$1,096.48	$1,258.93	$1,412.54