Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.42 / $18.42 / $28.28	Facility	26	$18.42	$18.42	$28.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.92 / $113.59 / $172.94	Professional		$85.92	$113.59	$172.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $18.42 / $50.59	Professional	26	$16.32	$18.42	$50.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.83 / $90.20 / $141.41	Professional	TC	$69.83	$90.20	$141.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.69 / $147.91 / $213.89	Professional		$104.69	$147.91	$213.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $25.14 / $36.43	Professional	26	$18.93	$25.14	$36.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.86 / $122.95 / $181.31	Professional	TC	$87.86	$122.95	$181.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $110.51 / $195.77	Professional		$77.72	$110.51	$195.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.94 / $23.49 / $38.65	Professional	26	$15.94	$23.49	$38.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.67 / $86.62 / $153.68	Professional	TC	$62.67	$86.62	$153.68
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $181.67 / $181.67 / $194.93	Professional		$181.67	$181.67	$194.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.66 / $159.08 / $216.04	Professional		$127.66	$159.08	$216.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.82 / $28.43 / $38.61	Professional	26	$22.82	$28.43	$38.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $104.85 / $130.65 / $177.43	Professional	TC	$104.85	$130.65	$177.43
United Facility/Professional Professional Modifier Low / Median / High Price $95.51 / $150.22 / $233.05	Professional		$95.51	$150.22	$233.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $31.32 / $50.00	Professional	26	$18.72	$31.32	$50.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.70 / $125.87 / $187.46	Professional	TC	$77.70	$125.87	$187.46