Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.89 / $155.65 / $218.96	Facility	26	$91.89	$155.65	$218.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.82 / $425.00 / $525.00	Professional		$233.82	$425.00	$525.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.12 / $118.59 / $155.65	Professional	26	$59.12	$118.59	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.69 / $299.00 / $369.35	Professional	TC	$174.69	$299.00	$369.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.43 / $276.04 / $455.46	Professional		$215.43	$276.04	$455.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.20 / $64.45 / $100.81	Professional	26	$51.20	$64.45	$100.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.80 / $209.88 / $366.68	Professional	TC	$163.80	$209.88	$366.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $405.68 / $413.32 / $1,543.95	Professional		$405.68	$413.32	$1,543.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $60.61 / $64.87 / $81.09	Professional	26	$60.61	$64.87	$81.09
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $338.34 / $348.45 / $492.72	Professional	TC	$338.34	$348.45	$492.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.29 / $503.16 / $809.31	Professional		$214.29	$503.16	$809.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.91 / $74.64 / $140.47	Professional	26	$45.91	$74.64	$140.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.94 / $422.32 / $706.97	Professional	TC	$166.94	$422.32	$706.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $222.62 / $267.14 / $327.38	Professional		$222.62	$267.14	$327.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.58 / $62.48 / $75.76	Professional	26	$50.58	$62.48	$75.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $172.04 / $206.45 / $253.00	Professional	TC	$172.04	$206.45	$253.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $77.31 / $99.00 / $204.00	Facility	26	$77.31	$99.00	$204.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $78.34 / $427.00 / $864.00	Professional		$78.34	$427.00	$864.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $440.81 / $792.21	Professional		$81.28	$440.81	$792.21
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $60.47 / $80.17 / $126.94	Professional	26	$60.47	$80.17	$126.94
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $196.96 / $366.15 / $584.34	Professional	TC	$196.96	$366.15	$584.34
United Facility/Professional Professional Modifier Low / Median / High Price $206.40 / $356.98 / $719.82	Professional		$206.40	$356.98	$719.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.45 / $69.75 / $119.34	Professional	26	$44.45	$69.75	$119.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.60 / $299.77 / $607.96	Professional	TC	$157.60	$299.77	$607.96