Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $915.00 / $3,133.00 / $8,652.00	Facility		$915.00	$3,133.00	$8,652.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.70 / $39.70 / $49.72	Facility	26	$39.70	$39.70	$49.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $174.66 / $321.77	Professional		$140.13	$174.66	$321.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $45.26 / $126.19	Professional	26	$39.70	$45.26	$126.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $134.96 / $220.72	Professional	TC	$98.17	$134.96	$220.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.07 / $295.33 / $407.35	Professional		$225.07	$295.33	$407.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.81 / $57.49 / $79.30	Professional	26	$43.81	$57.49	$79.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $181.25 / $237.83 / $328.05	Professional	TC	$181.25	$237.83	$328.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.97 / $255.81 / $337.08	Professional		$159.97	$255.81	$337.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.91 / $60.79 / $92.26	Professional	26	$48.91	$60.79	$92.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.48 / $189.18 / $264.02	Professional	TC	$108.48	$189.18	$264.02
Denver HMP Facility/Professional Facility Modifier Low / Median / High Price $174.66 / $224.13 / $341.44	Facility		$174.66	$224.13	$341.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.94 / $265.36 / $332.54	Professional		$209.94	$265.36	$332.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.73 / $58.80 / $75.59	Professional	26	$47.73	$58.80	$75.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.21 / $205.04 / $260.25	Professional	TC	$162.21	$205.04	$260.25
United Facility/Professional Facility Modifier Low / Median / High Price $730.00 / $1,464.00 / $3,011.00	Facility		$730.00	$1,464.00	$3,011.00
United Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $249.56 / $415.93	Professional		$159.72	$249.56	$415.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.72 / $64.98 / $109.24	Professional	26	$48.72	$64.98	$109.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.61 / $194.99 / $522.00	Professional	TC	$120.61	$194.99	$522.00