Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $173.39 / $289.47	Facility	26	$118.59	$173.39	$289.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $509.44 / $844.00	Professional		$370.50	$509.44	$844.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.97 / $140.00 / $194.89	Professional	26	$101.97	$140.00	$194.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $365.10 / $593.53	Professional	TC	$281.41	$365.10	$593.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $365.71 / $467.67 / $763.56	Professional		$365.71	$467.67	$763.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.72 / $115.21 / $178.19	Professional	26	$91.72	$115.21	$178.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $272.89 / $348.98 / $576.96	Professional	TC	$272.89	$348.98	$576.96
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $665.45 / $684.80 / $3,315.22	Professional		$665.45	$684.80	$3,315.22
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $108.98 / $115.83 / $144.79	Professional	26	$108.98	$115.83	$144.79
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $553.48 / $563.71 / $864.22	Professional	TC	$553.48	$563.71	$864.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.69 / $811.10 / $1,422.69	Professional		$365.69	$811.10	$1,422.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $134.31 / $241.31	Professional	26	$82.56	$134.31	$241.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $280.48 / $620.83 / $1,215.63	Professional	TC	$280.48	$620.83	$1,215.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $374.39 / $449.27 / $550.58	Professional		$374.39	$449.27	$550.58
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 $282.49 / $338.99 / $415.43	Professional	TC	$282.49	$338.99	$415.43
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $153.65 / $177.00 / $315.36	Facility	26	$153.65	$177.00	$315.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $578.00 / $1,131.00	Professional		$144.00	$578.00	$1,131.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $144.11 / $675.89 / $1,321.04	Professional		$144.11	$675.89	$1,321.04
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $106.98 / $144.55 / $228.88	Professional	26	$106.98	$144.55	$228.88
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $345.34 / $600.49 / $843.41	Professional	TC	$345.34	$600.49	$843.41
United Facility/Professional Professional Modifier Low / Median / High Price $363.65 / $617.08 / $1,326.17	Professional		$363.65	$617.08	$1,326.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.09 / $121.49 / $198.05	Professional	26	$81.09	$121.49	$198.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $274.14 / $473.66 / $1,168.48	Professional	TC	$274.14	$473.66	$1,168.48