Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $175.22 / $782.34	Facility	26	$118.59	$175.22	$782.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.58 / $485.73 / $844.00	Professional		$330.58	$485.73	$844.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.70 / $154.00 / $234.65	Professional	26	$108.70	$154.00	$234.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.95 / $335.00 / $478.39	Professional	TC	$218.95	$335.00	$478.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.72 / $387.11 / $640.00	Professional		$302.72	$387.11	$640.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.96 / $123.76 / $191.45	Professional	26	$98.96	$123.76	$191.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $203.75 / $260.56 / $472.00	Professional	TC	$203.75	$260.56	$472.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $523.69 / $534.78 / $3,388.21	Professional		$523.69	$534.78	$3,388.21
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $123.53 / $129.12 / $170.75	Professional	26	$123.53	$129.12	$170.75
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $394.58 / $411.25 / $777.26	Professional	TC	$394.58	$411.25	$777.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.11 / $664.46 / $1,399.91	Professional		$299.11	$664.46	$1,399.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.03 / $146.47 / $268.48	Professional	26	$88.03	$146.47	$268.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.28 / $469.53 / $1,190.84	Professional	TC	$208.28	$469.53	$1,190.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.95 / $371.94 / $458.10	Professional		$309.95	$371.94	$458.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $97.93 / $120.97 / $145.32	Professional	26	$97.93	$120.97	$145.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $212.02 / $254.43 / $311.80	Professional	TC	$212.02	$254.43	$311.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $170.34 / $250.02 / $402.00	Facility	26	$170.34	$250.02	$402.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $154.00 / $466.00 / $1,122.00	Professional		$154.00	$466.00	$1,122.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $157.56 / $613.00 / $1,354.19	Professional		$157.56	$613.00	$1,354.19
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $115.75 / $156.72 / $243.95	Professional	26	$115.75	$156.72	$243.95
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $253.09 / $470.49 / $823.81	Professional	TC	$253.09	$470.49	$823.81
United Facility/Professional Professional Modifier Low / Median / High Price $295.82 / $544.84 / $1,478.23	Professional		$295.82	$544.84	$1,478.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.69 / $136.71 / $211.92	Professional	26	$84.69	$136.71	$211.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $202.52 / $386.36 / $1,134.22	Professional	TC	$202.52	$386.36	$1,134.22