Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.10 / $49.10 / $49.11	Facility	26	$49.10	$49.10	$49.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.88 / $149.74 / $250.06	Professional		$119.88	$149.74	$250.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $49.11 / $75.62	Professional	26	$42.14	$49.11	$75.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.73 / $103.82 / $165.99	Professional	TC	$75.73	$103.82	$165.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.35 / $173.39 / $479.83	Professional		$115.35	$173.39	$479.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.44 / $64.53 / $92.64	Professional	26	$48.44	$64.53	$92.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.96 / $114.86 / $301.50	Professional	TC	$63.96	$114.86	$301.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.25 / $92.25 / $92.25	Facility	26	$92.25	$92.25	$92.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $207.04 / $400.00	Professional		$128.77	$207.04	$400.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $59.17 / $99.90	Professional	26	$40.54	$59.17	$99.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.48 / $138.19 / $256.02	Professional	TC	$84.48	$138.19	$256.02
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $247.35 / $247.35 / $262.81	Professional		$247.35	$247.35	$262.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.81 / $220.61 / $430.00	Professional		$173.81	$220.61	$430.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.01 / $72.34 / $166.23	Professional	26	$57.01	$72.34	$166.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $116.81 / $148.25 / $341.18	Professional	TC	$116.81	$148.25	$341.18
United Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $240.88 / $369.14	Professional		$153.91	$240.88	$369.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.30 / $79.11 / $121.13	Professional	26	$41.30	$79.11	$121.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.81 / $155.90 / $248.01	Professional	TC	$100.81	$155.90	$248.01