Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $169.73 / $310.79	Facility	26	$118.59	$169.73	$310.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.81 / $476.10 / $898.58	Professional		$347.81	$476.10	$898.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.18 / $140.00 / $201.60	Professional	26	$99.18	$140.00	$201.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.16 / $340.00 / $702.41	Professional	TC	$242.16	$340.00	$702.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.61 / $408.72 / $675.73	Professional		$319.61	$408.72	$675.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.42 / $114.88 / $177.60	Professional	26	$91.42	$114.88	$177.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $227.11 / $290.43 / $488.56	Professional	TC	$227.11	$290.43	$488.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $589.77 / $607.41 / $3,314.07	Professional		$589.77	$607.41	$3,314.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $108.59 / $115.83 / $144.79	Professional	26	$108.59	$115.83	$144.79
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $469.12 / $491.58 / $864.26	Professional	TC	$469.12	$491.58	$864.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.52 / $729.41 / $1,334.07	Professional		$293.52	$729.41	$1,334.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.26 / $130.31 / $227.06	Professional	26	$82.26	$130.31	$227.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.66 / $556.27 / $1,192.68	Professional	TC	$232.66	$556.27	$1,192.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.85 / $393.41 / $483.06	Professional		$327.85	$393.41	$483.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.90 / $113.53 / $136.33	Professional	26	$91.90	$113.53	$136.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $235.95 / $283.14 / $346.99	Professional	TC	$235.95	$283.14	$346.99
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $155.10 / $176.00 / $314.38	Facility	26	$155.10	$176.00	$314.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $577.00 / $1,206.00	Professional		$144.00	$577.00	$1,206.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $631.34 / $1,291.00	Professional		$145.13	$631.34	$1,291.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $106.75 / $144.55 / $228.88	Professional	26	$106.75	$144.55	$228.88
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $284.20 / $527.65 / $828.56	Professional	TC	$284.20	$527.65	$828.56
United Facility/Professional Professional Modifier Low / Median / High Price $314.44 / $564.85 / $1,327.09	Professional		$314.44	$564.85	$1,327.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.23 / $129.97 / $197.65	Professional	26	$73.23	$129.97	$197.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.42 / $432.57 / $1,137.08	Professional	TC	$227.42	$432.57	$1,137.08