Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $178.20 / $297.06	Facility	26	$118.59	$178.20	$297.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.58 / $517.25 / $905.58	Professional		$348.58	$517.25	$905.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.02 / $155.29 / $230.81	Professional	26	$104.02	$155.29	$230.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.85 / $366.76 / $699.23	Professional	TC	$240.85	$366.76	$699.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.54 / $409.90 / $677.68	Professional		$320.54	$409.90	$677.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.65 / $117.65 / $181.73	Professional	26	$94.65	$117.65	$181.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $225.88 / $288.86 / $488.56	Professional	TC	$225.88	$288.86	$488.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $590.04 / $688.61 / $3,337.22	Professional		$590.04	$688.61	$3,337.22
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $117.03 / $118.09 / $148.74	Professional	26	$117.03	$118.09	$148.74
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $466.58 / $570.52 / $884.31	Professional	TC	$466.58	$570.52	$884.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.58 / $766.32 / $1,432.48	Professional		$318.58	$766.32	$1,432.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.18 / $138.83 / $246.09	Professional	26	$84.18	$138.83	$246.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.73 / $553.61 / $1,198.21	Professional	TC	$231.73	$553.61	$1,198.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $328.64 / $394.37 / $484.51	Professional		$328.64	$394.37	$484.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.68 / $115.72 / $138.97	Professional	26	$93.68	$115.72	$138.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $234.97 / $281.95 / $345.54	Professional	TC	$234.97	$281.95	$345.54
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $161.40 / $218.00 / $390.46	Facility	26	$161.40	$218.00	$390.46
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $575.00 / $1,206.00	Professional		$144.00	$575.00	$1,206.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $149.60 / $632.11 / $1,330.13	Professional		$149.60	$632.11	$1,330.13
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $111.29 / $148.46 / $233.42	Professional	26	$111.29	$148.46	$233.42
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $282.77 / $524.99 / $828.56	Professional	TC	$282.77	$524.99	$828.56
United Facility/Professional Professional Modifier Low / Median / High Price $315.31 / $599.75 / $1,458.23	Professional		$315.31	$599.75	$1,458.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.66 / $128.06 / $201.57	Professional	26	$82.66	$128.06	$201.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.27 / $428.21 / $1,194.28	Professional	TC	$226.27	$428.21	$1,194.28