Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.18 / $45.09 / $114.31	Facility	26	$25.18	$45.09	$114.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $84.55 / $106.73	Professional		$71.77	$84.55	$106.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.56 / $56.27 / $78.43	Professional	TC	$47.56	$56.27	$78.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.56 / $103.00 / $154.04	Professional		$80.56	$103.00	$154.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.02 / $71.36 / $105.80	Professional	TC	$55.02	$71.36	$105.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $110.05 / $111.20 / $237.70	Professional		$110.05	$111.20	$237.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $69.43 / $77.15 / $97.98	Professional	TC	$69.43	$77.15	$97.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Facility	26	$31.62	$31.62	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.36 / $119.97 / $204.80	Professional		$71.36	$119.97	$204.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.69 / $82.19 / $147.81	Professional	TC	$48.69	$82.19	$147.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.34 / $101.20 / $124.32	Professional		$84.34	$101.20	$124.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $30.51 / $37.76	Professional	26	$24.70	$30.51	$37.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $59.64 / $71.56 / $87.70	Professional	TC	$59.64	$71.56	$87.70
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $42.90 / $48.00 / $85.83	Facility	26	$42.90	$48.00	$85.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $103.02 / $191.00	Professional		$40.00	$103.02	$191.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $39.84 / $114.01 / $201.04	Professional		$39.84	$114.01	$201.04
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $59.89 / $94.83 / $143.41	Professional	TC	$59.89	$94.83	$143.41
United Facility/Professional Professional Modifier Low / Median / High Price $75.33 / $117.87 / $185.56	Professional		$75.33	$117.87	$185.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.81 / $80.22 / $134.97	Professional	TC	$52.81	$80.22	$134.97