Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.84 / $133.28 / $161.01	Facility	26	$129.84	$133.28	$161.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $699.55	Professional		$370.50	$475.00	$699.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.29 / $140.00 / $324.42	Professional	26	$102.29	$140.00	$324.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.80 / $335.00 / $501.24	Professional	TC	$269.80	$335.00	$501.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $418.88 / $552.23 / $1,349.32	Professional		$418.88	$552.23	$1,349.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.17 / $144.05 / $209.80	Professional	26	$107.17	$144.05	$209.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $315.50 / $419.33 / $1,021.59	Professional	TC	$315.50	$419.33	$1,021.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.56 / $204.56 / $204.56	Facility	26	$204.56	$204.56	$204.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $385.62 / $628.33 / $1,400.87	Professional		$385.62	$628.33	$1,400.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.94 / $135.75 / $226.61	Professional	26	$91.94	$135.75	$226.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.74 / $531.83 / $1,092.03	Professional	TC	$291.74	$531.83	$1,092.03
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $729.44 / $729.44 / $780.02	Professional		$729.44	$729.44	$780.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.58 / $650.58 / $867.44	Professional		$512.58	$650.58	$867.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $129.84 / $164.80 / $376.97	Professional	26	$129.84	$164.80	$376.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $382.73 / $485.78 / $825.00	Professional	TC	$382.73	$485.78	$825.00
United Facility/Professional Professional Modifier Low / Median / High Price $538.41 / $786.56 / $1,483.04	Professional		$538.41	$786.56	$1,483.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.90 / $175.54 / $276.47	Professional	26	$92.90	$175.54	$276.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $402.04 / $613.52 / $1,053.22	Professional	TC	$402.04	$613.52	$1,053.22