Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.29 / $37.02 / $87.35	Facility	26	$20.29	$37.02	$87.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.88 / $121.23 / $144.80	Professional		$93.88	$121.23	$144.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $100.96 / $122.48	Professional	TC	$78.06	$100.96	$122.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.94 / $158.66 / $231.93	Professional		$110.94	$158.66	$231.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.21 / $133.28 / $194.82	Professional	TC	$86.21	$133.28	$194.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $122.99 / $157.31 / $310.04	Professional		$122.99	$157.31	$310.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $97.41 / $122.86 / $153.57	Professional	TC	$97.41	$122.86	$153.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.28 / $142.53 / $280.48	Professional		$101.28	$142.53	$280.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.27 / $112.56 / $235.59	Professional	TC	$80.27	$112.56	$235.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.82 / $161.78 / $198.26	Professional		$134.82	$161.78	$198.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $25.67 / $30.56	Professional	26	$20.78	$25.67	$30.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $114.04 / $136.84 / $167.70	Professional	TC	$114.04	$136.84	$167.70
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $33.00 / $35.47 / $73.41	Facility	26	$33.00	$35.47	$73.41
Medcost Facility/Professional Professional Modifier Low / Median / High Price $31.56 / $129.05 / $208.00	Professional		$31.56	$129.05	$208.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $33.21 / $134.72 / $282.19	Professional		$33.21	$134.72	$282.19
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $99.64 / $142.11 / $247.54	Professional	TC	$99.64	$142.11	$247.54
United Facility/Professional Professional Modifier Low / Median / High Price $94.29 / $138.01 / $237.17	Professional		$94.29	$138.01	$237.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.40 / $110.62 / $192.94	Professional	TC	$76.40	$110.62	$192.94