Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.60 / $145.44 / $223.27	Facility	26	$105.60	$145.44	$223.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.63 / $471.63 / $640.50	Professional		$271.63	$471.63	$640.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.12 / $118.59 / $155.65	Professional	26	$65.12	$118.59	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.98 / $335.00 / $455.72	Professional	TC	$217.98	$335.00	$455.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.70 / $365.93 / $608.80	Professional		$281.70	$365.93	$608.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.79 / $71.58 / $113.71	Professional	26	$57.79	$71.58	$113.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $224.28 / $291.24 / $484.71	Professional	TC	$224.28	$291.24	$484.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $461.40 / $491.98 / $1,548.01	Professional		$461.40	$491.98	$1,548.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $68.97 / $73.76 / $92.20	Professional	26	$68.97	$73.76	$92.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $384.77 / $418.22 / $531.14	Professional	TC	$384.77	$418.22	$531.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.27 / $536.00 / $872.97	Professional		$289.27	$536.00	$872.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.25 / $84.83 / $154.84	Professional	26	$52.25	$84.83	$154.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.44 / $455.23 / $738.31	Professional	TC	$235.44	$455.23	$738.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.14 / $354.16 / $434.03	Professional		$295.14	$354.16	$434.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.55 / $71.09 / $86.16	Professional	26	$57.55	$71.09	$86.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $237.59 / $285.11 / $349.40	Professional	TC	$237.59	$285.11	$349.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $96.62 / $111.00 / $199.07	Facility	26	$96.62	$111.00	$199.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $449.00 / $776.00	Professional		$91.00	$449.00	$776.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $91.24 / $445.46 / $732.18	Professional		$91.24	$445.46	$732.18
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $68.15 / $90.71 / $143.62	Professional	26	$68.15	$90.71	$143.62
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $233.74 / $388.78 / $536.63	Professional	TC	$233.74	$388.78	$536.63
United Facility/Professional Professional Modifier Low / Median / High Price $284.26 / $469.04 / $789.09	Professional		$284.26	$469.04	$789.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.62 / $79.40 / $133.63	Professional	26	$49.62	$79.40	$133.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.12 / $374.18 / $672.99	Professional	TC	$229.12	$374.18	$672.99