Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $99.05 / $118.14	Professional		$77.42	$99.05	$118.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.57 / $17.13 / $22.64	Professional	26	$14.57	$17.13	$22.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.96 / $81.83 / $99.28	Professional	TC	$63.96	$81.83	$99.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.41 / $131.97 / $193.18	Professional		$80.41	$131.97	$193.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.13 / $21.58 / $32.76	Professional	26	$17.13	$21.58	$32.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.38 / $110.58 / $162.07	Professional	TC	$60.38	$110.58	$162.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $83.10 / $129.61 / $213.63	Professional		$83.10	$129.61	$213.63
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $20.02 / $25.43	Professional	26	$20.02	$20.02	$25.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $63.08 / $99.59 / $124.49	Professional	TC	$63.08	$99.59	$124.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $104.95 / $233.78	Professional		$67.34	$104.95	$233.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.27 / $23.95 / $42.77	Professional	26	$15.27	$23.95	$42.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.83 / $84.20 / $199.21	Professional	TC	$49.83	$84.20	$199.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.39 / $127.67 / $156.46	Professional		$106.39	$127.67	$156.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.93 / $20.92 / $25.73	Professional	26	$16.93	$20.92	$25.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $89.46 / $107.36 / $131.56	Professional	TC	$89.46	$107.36	$131.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $85.00 / $163.00	Professional		$25.00	$85.00	$163.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $25.78 / $106.27 / $221.50	Professional		$25.78	$106.27	$221.50
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $27.10 / $42.91	Professional	26	$19.39	$27.10	$42.91
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $65.05 / $118.60 / $204.23	Professional	TC	$65.05	$118.60	$204.23
United Facility/Professional Professional Modifier Low / Median / High Price $58.30 / $108.68 / $197.36	Professional		$58.30	$108.68	$197.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.94 / $23.21 / $35.09	Professional	26	$14.94	$23.21	$35.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.50 / $88.85 / $154.60	Professional	TC	$41.50	$88.85	$154.60