Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.43 / $98.43 / $126.16	Facility	26	$98.43	$98.43	$126.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.60 / $854.63 / $1,371.59	Professional		$645.60	$854.63	$1,371.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.17 / $98.43 / $243.00	Professional	26	$93.17	$98.43	$243.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $600.79 / $756.20 / $1,223.50	Professional	TC	$600.79	$756.20	$1,223.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $896.72 / $1,228.00 / $1,793.45	Professional		$896.72	$1,228.00	$1,793.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.25 / $134.58 / $196.56	Professional	26	$100.25	$134.58	$196.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $798.44 / $1,093.41 / $1,596.89	Professional	TC	$798.44	$1,093.41	$1,596.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $858.38 / $1,241.66 / $1,882.30	Professional		$858.38	$1,241.66	$1,882.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.91 / $127.66 / $200.48	Professional	26	$92.91	$127.66	$200.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $761.91 / $1,098.65 / $1,668.11	Professional	TC	$761.91	$1,098.65	$1,668.11
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $1,505.77 / $1,505.77 / $1,626.30	Professional		$1,505.77	$1,505.77	$1,626.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $813.93 / $1,286.01 / $1,649.91	Professional		$813.93	$1,286.01	$1,649.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.74 / $148.11 / $180.92	Professional	26	$93.74	$148.11	$180.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $720.19 / $1,137.90 / $1,389.97	Professional	TC	$720.19	$1,137.90	$1,389.97
United Facility/Professional Professional Modifier Low / Median / High Price $811.78 / $1,529.04 / $2,402.62	Professional		$811.78	$1,529.04	$2,402.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.90 / $167.46 / $261.64	Professional	26	$88.90	$167.46	$261.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $722.88 / $1,361.58 / $2,398.73	Professional	TC	$722.88	$1,361.58	$2,398.73