Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.54 / $337.90 / $1,023.12	Facility		$87.54	$337.90	$1,023.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.59 / $10.92 / $16.25	Facility	26	$8.59	$10.92	$16.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.03 / $280.60 / $646.00	Facility	TC	$31.03	$280.60	$646.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $41.14 / $100.80	Professional		$18.17	$41.14	$100.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $11.21 / $32.35	Professional	26	$7.44	$11.21	$32.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.23 / $41.60 / $114.57	Professional	50	$29.23	$41.60	$114.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $31.04 / $54.42	Professional	TC	$21.64	$31.04	$54.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.32 / $112.87 / $179.31	Facility		$85.32	$112.87	$179.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $53.00 / $77.94	Professional		$36.01	$53.00	$77.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.03 / $11.86 / $17.03	Professional	26	$9.03	$11.86	$17.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.95 / $53.43 / $66.03	Professional	50	$40.95	$53.43	$66.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.86 / $41.76 / $61.00	Professional	TC	$27.86	$41.76	$61.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.90 / $180.22 / $351.64	Facility		$48.90	$180.22	$351.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $41.90 / $73.77	Professional		$26.86	$41.90	$73.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.08 / $18.98	Professional	26	$7.59	$11.08	$18.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $29.88 / $53.40	Professional	TC	$19.21	$29.88	$53.40
Denver HMP Facility/Professional Facility Modifier Low / Median / High Price $36.39 / $46.36 / $71.34	Facility		$36.39	$46.36	$71.34
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $69.84 / $74.80	Professional		$69.84	$69.84	$74.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.08 / $61.16 / $83.05	Professional		$49.08	$61.16	$83.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.65 / $13.27 / $18.02	Professional	26	$10.65	$13.27	$18.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.43 / $47.89 / $65.03	Professional	TC	$38.43	$47.89	$65.03
United Facility/Professional Facility Modifier Low / Median / High Price $182.03 / $182.03 / $182.03	Facility		$182.03	$182.03	$182.03
United Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $55.40 / $83.12	Professional		$30.70	$55.40	$83.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $14.43 / $21.79	Professional	26	$8.57	$14.43	$21.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $39.53 / $58.58	Professional	TC	$21.84	$39.53	$58.58