Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $178.20 / $297.06	Facility	26	$118.59	$178.20	$297.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.94 / $494.18 / $904.30	Professional		$347.94	$494.18	$904.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.34 / $150.25 / $249.21	Professional	26	$104.34	$150.25	$249.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.54 / $344.10 / $697.97	Professional	TC	$239.54	$344.10	$697.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.31 / $408.33 / $675.09	Professional		$319.31	$408.33	$675.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.65 / $117.65 / $181.73	Professional	26	$94.65	$117.65	$181.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $224.65 / $287.27 / $488.56	Professional	TC	$224.65	$287.27	$488.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $587.51 / $686.79 / $3,337.22	Professional		$587.51	$686.79	$3,337.22
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $117.03 / $118.51 / $148.74	Professional	26	$117.03	$118.51	$148.74
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $464.05 / $568.28 / $880.83	Professional	TC	$464.05	$568.28	$880.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.36 / $764.30 / $1,432.48	Professional		$317.36	$764.30	$1,432.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.18 / $138.83 / $246.09	Professional	26	$84.18	$138.83	$246.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.50 / $551.04 / $1,193.60	Professional	TC	$230.50	$551.04	$1,193.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.33 / $392.80 / $482.63	Professional		$327.33	$392.80	$482.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.68 / $115.72 / $138.97	Professional	26	$93.68	$115.72	$138.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $233.66 / $280.39 / $343.61	Professional	TC	$233.66	$280.39	$343.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $161.40 / $185.00 / $334.47	Facility	26	$161.40	$185.00	$334.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $573.00 / $1,205.00	Professional		$144.00	$573.00	$1,205.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $149.60 / $638.12 / $1,330.13	Professional		$149.60	$638.12	$1,330.13
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $111.29 / $148.46 / $233.42	Professional	26	$111.29	$148.46	$233.42
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $282.05 / $523.65 / $828.56	Professional	TC	$282.05	$523.65	$828.56
United Facility/Professional Professional Modifier Low / Median / High Price $314.74 / $547.99 / $1,416.23	Professional		$314.74	$547.99	$1,416.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.00 / $130.90 / $201.97	Professional	26	$81.00	$130.90	$201.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.70 / $429.29 / $1,133.98	Professional	TC	$225.70	$429.29	$1,133.98