Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.73 / $143.91 / $211.09	Facility	26	$91.73	$143.91	$211.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.38 / $471.63 / $680.00	Professional		$230.38	$471.63	$680.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.53 / $123.41 / $182.68	Professional	26	$66.53	$123.41	$182.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,531.00 / $2,502.00 / $2,558.00	Professional	50	$1,531.00	$2,502.00	$2,558.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.80 / $335.00 / $483.88	Professional	TC	$178.80	$335.00	$483.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.74 / $270.77 / $447.68	Professional		$211.74	$270.77	$447.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.40 / $72.20 / $112.53	Professional	26	$57.40	$72.20	$112.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $317.62 / $406.17 / $671.52	Professional	50	$317.62	$406.17	$671.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.66 / $196.50 / $328.03	Professional	TC	$153.66	$196.50	$328.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $393.17 / $458.47 / $1,548.01	Professional		$393.17	$458.47	$1,548.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $68.18 / $72.91 / $91.14	Professional	26	$68.18	$72.91	$91.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $317.41 / $385.56 / $539.78	Professional	TC	$317.41	$385.56	$539.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.60 / $491.76 / $786.66	Professional		$210.60	$491.76	$786.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.65 / $84.20 / $154.84	Professional	26	$51.65	$84.20	$154.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.06 / $402.15 / $661.48	Professional	TC	$157.06	$402.15	$661.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $216.81 / $260.17 / $319.20	Professional		$216.81	$260.17	$319.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.22 / $70.69 / $85.67	Professional	26	$57.22	$70.69	$85.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $159.60 / $191.52 / $234.70	Professional	TC	$159.60	$191.52	$234.70
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $97.46 / $111.00 / $199.23	Facility	26	$97.46	$111.00	$199.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $415.00 / $766.00	Professional		$91.00	$415.00	$766.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $91.24 / $420.87 / $719.06	Professional		$91.24	$420.87	$719.06
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $68.15 / $90.23 / $142.86	Professional	26	$68.15	$90.23	$142.86
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $190.88 / $354.39 / $524.85	Professional	TC	$190.88	$354.39	$524.85
United Facility/Professional Professional Modifier Low / Median / High Price $207.58 / $373.34 / $792.10	Professional		$207.58	$373.34	$792.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.32 / $77.92 / $124.50	Professional	26	$48.32	$77.92	$124.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.72 / $271.14 / $662.32	Professional	TC	$152.72	$271.14	$662.32