Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.50 / $44.10 / $60.85	Facility	26	$38.50	$44.10	$60.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.69 / $92.36 / $137.84	Professional		$51.69	$92.36	$137.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $35.94 / $73.95	Professional	26	$24.78	$35.94	$73.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.37 / $44.47 / $98.28	Professional	TC	$11.37	$44.47	$98.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.41 / $80.58 / $127.52	Professional		$61.41	$80.58	$127.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.04 / $60.33 / $87.43	Professional	26	$42.04	$60.33	$87.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.95 / $131.72 / $216.24	Professional	50	$73.95	$131.72	$216.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.97 / $17.28 / $40.38	Professional	TC	$12.97	$17.28	$40.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.32 / $49.32 / $49.32	Facility	26	$49.32	$49.32	$49.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.59 / $108.74 / $202.99	Professional		$54.59	$108.74	$202.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.07 / $39.19 / $73.08	Professional	26	$27.07	$39.19	$73.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.00 / $80.23 / $142.78	Professional	TC	$12.00	$80.23	$142.78
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $100.23	Professional		$97.72	$97.72	$100.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.03 / $81.34 / $116.20	Professional		$66.03	$81.34	$116.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.50 / $64.68 / $90.75	Professional	26	$52.50	$64.68	$90.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $13.54 / $16.68 / $23.83	Professional	TC	$13.54	$16.68	$23.83
United Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $128.04 / $210.61	Professional		$87.60	$128.04	$210.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $51.39 / $88.16	Professional	26	$31.34	$51.39	$88.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.00 / $88.29 / $154.94	Professional	TC	$52.00	$88.29	$154.94