Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $433.50 / $1,750.90	Facility		$161.00	$433.50	$1,750.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.34 / $42.43 / $83.60	Facility	26	$33.34	$42.43	$83.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.78 / $89.42 / $159.53	Professional		$72.78	$89.42	$159.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $33.46 / $106.28	Professional	26	$28.30	$33.46	$106.28
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.94 / $189.99 / $641.46	Professional	50	$112.94	$189.99	$641.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.41 / $56.07 / $90.70	Professional	TC	$44.41	$56.07	$90.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.00 / $256.00 / $554.00	Facility		$186.00	$256.00	$554.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $125.69 / $179.83	Professional		$91.26	$125.69	$179.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.86 / $47.15 / $66.42	Professional	26	$33.86	$47.15	$66.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $114.39 / $131.94 / $188.41	Professional	50	$114.39	$131.94	$188.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.73 / $79.23 / $113.76	Professional	TC	$57.73	$79.23	$113.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.91 / $218.90 / $351.64	Facility		$87.91	$218.90	$351.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.03 / $37.03 / $37.03	Facility	26	$37.03	$37.03	$37.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $101.18 / $191.42	Professional		$79.19	$101.18	$191.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $39.33 / $74.91	Professional	26	$29.82	$39.33	$74.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.47 / $62.12 / $118.04	Professional	TC	$49.47	$62.12	$118.04
Denver HMP Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $107.30 / $160.96	Facility		$84.95	$107.30	$160.96
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $157.55 / $157.55 / $166.81	Professional		$157.55	$157.55	$166.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.45 / $131.15 / $187.35	Professional		$106.45	$131.15	$187.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $48.91 / $69.87	Professional	26	$39.70	$48.91	$69.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $66.75 / $82.24 / $117.48	Professional	TC	$66.75	$82.24	$117.48
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 $90.89 / $133.71 / $199.08	Professional		$90.89	$133.71	$199.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.28 / $51.98 / $74.83	Professional	26	$35.28	$51.98	$74.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.33 / $79.01 / $136.22	Professional	TC	$55.33	$79.01	$136.22