Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $155.65 / $285.75	Facility	26	$118.59	$155.65	$285.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.87 / $425.00 / $600.00	Professional		$276.87	$425.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.33 / $124.36 / $155.65	Professional	26	$82.33	$124.36	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.05 / $299.00 / $426.90	Professional	TC	$192.05	$299.00	$426.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $254.46 / $325.39 / $537.98	Professional		$254.46	$325.39	$537.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.37 / $92.58 / $144.76	Professional	26	$74.37	$92.58	$144.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $180.09 / $230.30 / $386.73	Professional	TC	$180.09	$230.30	$386.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $468.98 / $482.53 / $1,879.21	Professional		$468.98	$482.53	$1,879.21
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $87.30 / $93.65 / $117.06	Professional	26	$87.30	$93.65	$117.06
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $371.98 / $388.88 / $544.42	Professional	TC	$371.98	$388.88	$544.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.90 / $579.29 / $913.02	Professional		$252.90	$579.29	$913.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.13 / $107.77 / $195.15	Professional	26	$66.13	$107.77	$195.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.90 / $449.98 / $731.13	Professional	TC	$183.90	$449.98	$731.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $261.26 / $313.52 / $385.16	Professional		$261.26	$313.52	$385.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $73.17 / $90.38 / $110.40	Professional	26	$73.17	$90.38	$110.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $188.10 / $225.72 / $276.61	Professional	TC	$188.10	$225.72	$276.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $123.63 / $142.00 / $256.74	Facility	26	$123.63	$142.00	$256.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $113.93 / $466.00 / $872.00	Professional		$113.93	$466.00	$872.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $117.32 / $499.92 / $880.10	Professional		$117.32	$499.92	$880.10
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $87.62 / $116.83 / $184.99	Professional	26	$87.62	$116.83	$184.99
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $224.49 / $403.04 / $637.41	Professional	TC	$224.49	$403.04	$637.41
United Facility/Professional Professional Modifier Low / Median / High Price $250.24 / $453.20 / $835.30	Professional		$250.24	$453.20	$835.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.58 / $105.91 / $174.89	Professional	26	$65.58	$105.91	$174.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.63 / $318.29 / $700.24	Professional	TC	$179.63	$318.29	$700.24