Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $374.94 / $870.49	Facility		$82.00	$374.94	$870.49
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $11.91 / $13.40	Facility	26	$9.30	$11.91	$13.40
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.89 / $278.27 / $613.91	Facility	TC	$33.89	$278.27	$613.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.89 / $46.15 / $122.76	Professional		$12.89	$46.15	$122.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $12.54 / $37.39	Professional	26	$8.56	$12.54	$37.39
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.00 / $219.97 / $219.97	Professional	50	$138.00	$219.97	$219.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.84 / $20.64 / $24.42	Professional	52	$13.84	$20.64	$24.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $33.90 / $70.23	Professional	TC	$24.44	$33.90	$70.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.00 / $123.04 / $195.46	Facility		$93.00	$123.04	$195.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.69 / $58.94 / $86.08	Professional		$39.69	$58.94	$86.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $12.96 / $18.39	Professional	26	$9.59	$12.96	$18.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.01 / $58.80 / $72.51	Professional	50	$45.01	$58.80	$72.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.88 / $46.30 / $67.09	Professional	TC	$30.88	$46.30	$67.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.61 / $180.22 / $351.64	Facility		$55.61	$180.22	$351.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.65 / $46.20 / $82.43	Professional		$29.65	$46.20	$82.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $12.08 / $20.60	Professional	26	$8.21	$12.08	$20.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.14 / $33.65 / $60.44	Professional	TC	$21.14	$33.65	$60.44
Denver HMP Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $51.44 / $81.69	Facility		$40.01	$51.44	$81.69
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $76.13 / $76.13 / $81.56	Professional		$76.13	$76.13	$81.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.50 / $66.66 / $90.53	Professional		$53.50	$66.66	$90.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $14.35 / $19.48	Professional	26	$11.52	$14.35	$19.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.96 / $52.29 / $71.02	Professional	TC	$41.96	$52.29	$71.02
United Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $63.52 / $93.50	Professional		$33.72	$63.52	$93.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $15.78 / $24.35	Professional	26	$9.38	$15.78	$24.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.01 / $47.43 / $66.64	Professional	TC	$25.01	$47.43	$66.64