Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.58 / $93.01 / $118.14	Facility	26	$88.58	$93.01	$118.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.68 / $243.78 / $299.29	Professional		$144.68	$243.78	$299.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $82.40 / $138.49	Professional	26	$56.82	$82.40	$138.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.07 / $123.47 / $232.83	Professional	TC	$62.07	$123.47	$232.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.43 / $240.36 / $379.88	Professional		$176.43	$240.36	$379.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.22 / $124.90 / $183.68	Professional	26	$90.22	$124.90	$183.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.09 / $110.56 / $207.40	Professional	TC	$78.09	$110.56	$207.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.80 / $249.42 / $611.41	Professional		$150.80	$249.42	$611.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.64 / $95.41 / $186.10	Professional	26	$59.64	$95.41	$186.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.01 / $149.81 / $442.49	Professional	TC	$68.01	$149.81	$442.49
Denver HMP Facility/Professional Professional Modifier Low / Median / High Price $298.45 / $298.45 / $309.19	Professional		$298.45	$298.45	$309.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.73 / $261.35 / $354.93	Professional		$209.73	$261.35	$354.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $115.15 / $143.50 / $189.42	Professional	26	$115.15	$143.50	$189.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.56 / $117.84 / $160.03	Professional	TC	$94.56	$117.84	$160.03
United Facility/Professional Professional Modifier Low / Median / High Price $197.60 / $321.08 / $535.25	Professional		$197.60	$321.08	$535.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.88 / $141.81 / $233.05	Professional	26	$65.88	$141.81	$233.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.81 / $157.91 / $341.12	Professional	TC	$104.81	$157.91	$341.12