Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $69.18 / $251.19	Facility	26	$34.67	$69.18	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $213.80	Professional		$72.44	$104.71	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $66.07 / $138.04	Professional	TC	$45.71	$66.07	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $229.09	Professional		$100.00	$141.25	$229.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $93.33 / $144.54	Professional	TC	$64.57	$93.33	$144.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $134.90 / $616.60	Professional		$46.77	$134.90	$616.60
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $138.04 / $177.83	Professional	TC	$102.33	$138.04	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $64.57	Facility	26	$9.77	$45.71	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $158.49 / $275.42	Professional		$85.11	$158.49	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $102.33 / $190.55	Professional	TC	$52.48	$102.33	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $158.49	Professional		$107.15	$128.82	$158.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $45.71 / $58.88	Professional	26	$37.15	$45.71	$58.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $85.11 / $104.71	Professional	TC	$69.18	$85.11	$104.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $316.23	Professional		$234.42	$302.00	$316.23
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $85.11	Professional	26	$57.54	$72.44	$85.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $177.83	Professional		$112.20	$112.20	$177.83
Sentara Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $131.83 / $316.23	Professional		$48.98	$131.83	$316.23
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $102.33 / $186.21	Professional	TC	$69.18	$102.33	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $263.03	Professional		$83.18	$138.04	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $87.10 / $181.97	Professional	TC	$52.48	$87.10	$181.97