Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $155.65 / $242.81	Facility	26	$118.59	$155.65	$242.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.69 / $475.00 / $684.10	Professional		$322.69	$475.00	$684.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.88 / $126.00 / $155.65	Professional	26	$77.88	$126.00	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.49 / $336.27 / $478.88	Professional	TC	$242.49	$336.27	$478.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $297.48 / $380.42 / $628.94	Professional		$297.48	$380.42	$628.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.80 / $85.77 / $135.74	Professional	26	$68.80	$85.77	$135.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $227.42 / $290.82 / $480.81	Professional	TC	$227.42	$290.82	$480.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $531.83 / $548.05 / $1,857.85	Professional		$531.83	$548.05	$1,857.85
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $82.29 / $88.78 / $110.97	Professional	26	$82.29	$88.78	$110.97
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $440.40 / $459.28 / $583.29	Professional	TC	$440.40	$459.28	$583.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.14 / $590.51 / $962.91	Professional		$297.14	$590.51	$962.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.34 / $101.59 / $184.00	Professional	26	$62.34	$101.59	$184.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.65 / $482.71 / $765.26	Professional	TC	$232.65	$482.71	$765.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $305.27 / $366.32 / $448.93	Professional		$305.27	$366.32	$448.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.98 / $85.23 / $103.19	Professional	26	$68.98	$85.23	$103.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $236.27 / $283.52 / $347.46	Professional	TC	$236.27	$283.52	$347.46
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $117.86 / $134.00 / $240.15	Facility	26	$117.86	$134.00	$240.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $106.63 / $468.00 / $827.00	Professional		$106.63	$468.00	$827.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $108.63 / $542.40 / $871.58	Professional		$108.63	$542.40	$871.58
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $81.81 / $110.13 / $174.38	Professional	26	$81.81	$110.13	$174.38
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $285.63 / $488.55 / $659.54	Professional	TC	$285.63	$488.55	$659.54
United Facility/Professional Professional Modifier Low / Median / High Price $295.13 / $479.58 / $833.30	Professional		$295.13	$479.58	$833.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.26 / $94.04 / $151.47	Professional	26	$58.26	$94.04	$151.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.56 / $390.99 / $698.68	Professional	TC	$228.56	$390.99	$698.68