Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $126.08 / $230.92	Facility	26	$74.17	$126.08	$230.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.52 / $288.02 / $539.16	Professional		$231.52	$288.02	$539.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.58 / $89.07 / $177.74	Professional	26	$71.58	$89.07	$177.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $198.94 / $386.24	Professional	TC	$158.91	$198.94	$386.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.57 / $333.26 / $508.88	Professional		$257.57	$333.26	$508.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.29 / $93.73 / $144.56	Professional	26	$75.29	$93.73	$144.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $181.28 / $236.98 / $368.42	Professional	TC	$181.28	$236.98	$368.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $394.22 / $404.91 / $1,552.54	Professional		$394.22	$404.91	$1,552.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $115.82	Professional	26	$91.20	$91.20	$115.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $287.08 / $313.70 / $439.18	Professional	TC	$287.08	$313.70	$439.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.94 / $508.77 / $824.30	Professional		$246.94	$508.77	$824.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.95 / $108.83 / $196.74	Professional	26	$66.95	$108.83	$196.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.57 / $386.81 / $655.19	Professional	TC	$177.57	$386.81	$655.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.06 / $322.87 / $396.48	Professional		$269.06	$322.87	$396.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.08 / $91.51 / $111.25	Professional	26	$74.08	$91.51	$111.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $233.98 / $286.74	Professional	TC	$194.98	$233.98	$286.74
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $125.93 / $145.00 / $256.95	Facility	26	$125.93	$145.00	$256.95
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.87 / $360.00 / $909.00	Professional		$114.87	$360.00	$909.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $118.56 / $435.78 / $727.02	Professional		$118.56	$435.78	$727.02
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $88.14 / $122.35 / $185.75	Professional	26	$88.14	$122.35	$185.75
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $181.37 / $339.00 / $508.82	Professional	TC	$181.37	$339.00	$508.82
United Facility/Professional Professional Modifier Low / Median / High Price $238.80 / $388.05 / $747.88	Professional		$238.80	$388.05	$747.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.36 / $98.45 / $155.72	Professional	26	$65.36	$98.45	$155.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.62 / $300.88 / $613.62	Professional	TC	$167.62	$300.88	$613.62