Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $962.43 / $3,940.40 / $9,611.00	Facility		$962.43	$3,940.40	$9,611.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,728.20 / $2,728.20 / $8,019.00	Facility	50	$2,728.20	$2,728.20	$8,019.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $128.32 / $128.32 / $128.32	Facility	53	$128.32	$128.32	$128.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $481.22 / $481.22 / $481.22	Facility	54	$481.22	$481.22	$481.22
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $96.24 / $96.24 / $96.24	Facility	55	$96.24	$96.24	$96.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $404.66 / $641.62 / $885.47	Professional		$404.66	$641.62	$885.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $3,083.88 / $3,083.88 / $3,083.89	Professional	50	$3,083.88	$3,083.88	$3,083.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $202.33 / $320.81 / $343.42	Professional	52	$202.33	$320.81	$343.42
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $303.50 / $481.22 / $646.97	Professional	54	$303.50	$481.22	$646.97
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $60.70 / $96.24 / $98.79	Professional	55	$60.70	$96.24	$98.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,434.00 / $5,126.00 / $9,729.00	Facility		$3,434.00	$5,126.00	$9,729.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $583.54 / $750.11 / $1,067.49	Professional		$583.54	$750.11	$1,067.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $722.98 / $875.33 / $951.45	Professional	50	$722.98	$875.33	$951.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $523.98 / $815.78 / $1,257.53	Professional		$523.98	$815.78	$1,257.53
Denver HMP Facility/Professional Facility Modifier Low / Median / High Price $614.88 / $848.55 / $1,127.79	Facility		$614.88	$848.55	$1,127.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $561.41 / $743.21 / $1,005.20	Professional		$561.41	$743.21	$1,005.20
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $898.26 / $898.26 / $898.26	Professional	54	$898.26	$898.26	$898.26
United Facility/Professional Facility Modifier Low / Median / High Price $2,440.00 / $4,965.00 / $11,259.00	Facility		$2,440.00	$4,965.00	$11,259.00
United Facility/Professional Professional Modifier Low / Median / High Price $617.99 / $822.00 / $1,313.24	Professional		$617.99	$822.00	$1,313.24