Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.55 / $28.55 / $28.55	Facility	26	$28.55	$28.55	$28.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $111.42 / $163.50	Professional		$90.73	$111.42	$163.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.95 / $27.28 / $35.85	Professional	26	$21.95	$27.28	$35.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $87.61 / $131.59	Professional	TC	$66.45	$87.61	$131.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.34 / $191.28 / $277.22	Professional		$123.34	$191.28	$277.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $39.57 / $56.93	Professional	26	$29.70	$39.57	$56.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.00 / $152.00 / $220.28	Professional	TC	$102.00	$152.00	$220.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.76 / $138.66 / $246.70	Professional		$82.76	$138.66	$246.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.91 / $36.54 / $62.47	Professional	26	$24.91	$36.54	$62.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.85 / $102.48 / $187.37	Professional	TC	$57.85	$102.48	$187.37
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $233.54 / $233.54 / $250.58	Professional		$233.54	$233.54	$250.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.11 / $204.51 / $277.73	Professional		$164.11	$204.51	$277.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $44.05 / $59.82	Professional	26	$35.35	$44.05	$59.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $128.75 / $160.44 / $217.89	Professional	TC	$128.75	$160.44	$217.89
United Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $187.85 / $294.95	Professional		$101.95	$187.85	$294.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.77 / $48.51 / $97.95	Professional	26	$27.77	$48.51	$97.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.58 / $144.46 / $211.90	Professional	TC	$73.58	$144.46	$211.90