Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.16 / $131.16 / $2,971.00	Facility	26	$77.16	$131.16	$2,971.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $320.06 / $547.46	Professional		$275.00	$320.06	$547.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $93.03 / $151.87	Professional	26	$74.45	$93.03	$151.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $207.19 / $228.41 / $390.60	Professional	TC	$207.19	$228.41	$390.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $280.80 / $356.08 / $601.10	Professional		$280.80	$356.08	$601.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.66 / $97.56 / $157.30	Professional	26	$76.66	$97.56	$157.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.74 / $258.87 / $441.18	Professional	TC	$199.74	$258.87	$441.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $434.80 / $437.42 / $2,931.70	Professional		$434.80	$437.42	$2,931.70
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $96.80 / $107.45 / $150.04	Professional	26	$96.80	$107.45	$150.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $323.27 / $340.62 / $466.24	Professional	TC	$323.27	$340.62	$466.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.40 / $98.40 / $98.40	Facility	26	$98.40	$98.40	$98.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.64 / $448.82 / $809.85	Professional		$267.64	$448.82	$809.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $113.57 / $205.49	Professional	26	$69.70	$113.57	$205.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.16 / $327.08 / $574.22	Professional	TC	$192.16	$327.08	$574.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $294.36 / $353.23 / $433.17	Professional		$294.36	$353.23	$433.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $77.73 / $96.02 / $115.74	Professional	26	$77.73	$96.02	$115.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $216.62 / $259.95 / $318.56	Professional	TC	$216.62	$259.95	$318.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $128.69 / $129.90 / $309.00	Facility	26	$128.69	$129.90	$309.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $321.00 / $569.00	Professional		$116.00	$321.00	$569.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $395.48 / $733.80	Professional		$115.00	$395.48	$733.80
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $87.12 / $118.63 / $193.10	Professional	26	$87.12	$118.63	$193.10
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $236.64 / $322.00 / $536.51	Professional	TC	$236.64	$322.00	$536.51
United Facility/Professional Professional Modifier Low / Median / High Price $259.73 / $395.57 / $625.32	Professional		$259.73	$395.57	$625.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.59 / $111.53 / $168.32	Professional	26	$68.59	$111.53	$168.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.42 / $284.04 / $477.25	Professional	TC	$170.42	$284.04	$477.25