Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.25 / $114.18 / $135.47	Facility	26	$94.25	$114.18	$135.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.54 / $392.89 / $510.04	Professional		$255.54	$392.89	$510.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.63 / $97.62 / $289.08	Professional	26	$82.63	$97.62	$289.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $309.93 / $385.85	Professional	TC	$169.13	$309.93	$385.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.88 / $350.00 / $872.14	Professional		$276.88	$350.00	$872.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.19 / $122.01 / $176.38	Professional	26	$90.19	$122.01	$176.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $267.98 / $662.73	Professional	TC	$190.00	$267.98	$662.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.14 / $173.14 / $173.14	Facility	26	$173.14	$173.14	$173.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.30 / $455.34 / $858.00	Professional		$274.30	$455.34	$858.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.31 / $112.32 / $191.80	Professional	26	$77.31	$112.32	$191.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.55 / $340.00 / $684.75	Professional	TC	$192.55	$340.00	$684.75
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $502.48 / $502.48 / $534.76	Professional		$502.48	$502.48	$534.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $353.09 / $440.01 / $638.28	Professional		$353.09	$440.01	$638.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.41 / $138.86 / $316.97	Professional	26	$109.41	$138.86	$316.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $243.70 / $309.05 / $525.00	Professional	TC	$243.70	$309.05	$525.00
United Facility/Professional Professional Modifier Low / Median / High Price $366.79 / $523.33 / $994.51	Professional		$366.79	$523.33	$994.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.31 / $150.15 / $232.78	Professional	26	$79.31	$150.15	$232.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.20 / $375.78 / $628.29	Professional	TC	$236.20	$375.78	$628.29