Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.29 / $63.66 / $149.22	Facility	26	$35.29	$63.66	$149.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.92 / $97.03 / $138.69	Professional		$72.92	$97.03	$138.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.83 / $60.95 / $100.62	Professional	TC	$45.83	$60.95	$100.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.92 / $128.51 / $180.57	Professional		$96.92	$128.51	$180.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.39 / $82.14 / $123.64	Professional	TC	$61.39	$82.14	$123.64
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $137.61 / $151.18 / $616.52	Professional		$137.61	$151.18	$616.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $94.20 / $99.50 / $176.14	Professional	TC	$94.20	$99.50	$176.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.47 / $45.47 / $45.47	Facility	26	$45.47	$45.47	$45.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.84 / $158.87 / $274.52	Professional		$84.84	$158.87	$274.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.89 / $103.71 / $195.20	Professional	TC	$53.89	$103.71	$195.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.07 / $123.89 / $152.80	Professional		$103.07	$123.89	$152.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $44.34 / $52.94	Professional	26	$35.90	$44.34	$52.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.18 / $80.61 / $98.79	Professional	TC	$67.18	$80.61	$98.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $59.48 / $67.00 / $120.12	Facility	26	$59.48	$67.00	$120.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $54.72 / $114.00 / $221.00	Professional		$54.72	$114.00	$221.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $152.79 / $250.07	Professional		$54.01	$152.79	$250.07
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $107.90 / $169.30	Professional	TC	$70.73	$107.90	$169.30
United Facility/Professional Professional Modifier Low / Median / High Price $83.04 / $136.16 / $271.93	Professional		$83.04	$136.16	$271.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.87 / $82.22 / $181.69	Professional	TC	$52.87	$82.22	$181.69