Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.55 / $27.55 / $27.56	Facility	26	$27.55	$27.55	$27.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $121.55 / $219.82	Professional		$97.57	$121.55	$219.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $25.92 / $41.62	Professional	26	$20.69	$25.92	$41.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.93 / $95.87 / $178.18	Professional	TC	$73.93	$95.87	$178.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.18 / $194.09 / $279.25	Professional		$134.18	$194.09	$279.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.56 / $38.43 / $54.90	Professional	26	$28.56	$38.43	$54.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.97 / $155.27 / $225.02	Professional	TC	$106.97	$155.27	$225.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $141.26 / $248.40	Professional		$90.81	$141.26	$248.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.21 / $59.42	Professional	26	$23.99	$35.21	$59.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.22 / $104.85 / $186.96	Professional	TC	$66.22	$104.85	$186.96
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $242.50 / $242.50 / $260.55	Professional		$242.50	$242.50	$260.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.40 / $212.35 / $288.38	Professional		$170.40	$212.35	$288.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $42.51 / $57.73	Professional	26	$34.11	$42.51	$57.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $136.28 / $169.82 / $230.63	Professional	TC	$136.28	$169.82	$230.63
United Facility/Professional Professional Modifier Low / Median / High Price $105.68 / $183.51 / $319.77	Professional		$105.68	$183.51	$319.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $45.04 / $68.73	Professional	26	$27.23	$45.04	$68.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.26 / $148.82 / $235.47	Professional	TC	$78.26	$148.82	$235.47