Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $524.81 / $977.24	Facility		$97.72	$524.81	$977.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $42.66 / $177.83	Facility	26	$25.12	$42.66	$177.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $58.88 / $331.13 / $891.25	Facility	TC	$58.88	$331.13	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $331.13	Professional		$72.44	$109.65	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.02 / $102.33	Professional	26	$25.12	$38.02	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $70.79 / $158.49	Professional	TC	$50.12	$70.79	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $363.08 / $446.68	Facility		$302.00	$363.08	$446.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $173.78	Professional		$85.11	$117.49	$173.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $37.15 / $53.70	Professional	26	$26.92	$37.15	$53.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $79.43 / $117.49	Professional	TC	$57.54	$79.43	$117.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $87.10 / $257.04	Professional		$26.30	$87.10	$257.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $29.51 / $44.67	Professional	26	$29.51	$29.51	$44.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $61.66 / $104.71	Professional	TC	$61.66	$61.66	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $251.19 / $562.34	Facility		$144.54	$251.19	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $45.71	Facility	26	$6.76	$31.62	$45.71
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $13.80 / $64.57 / $91.20	Facility	TC	$13.80	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $194.98	Professional		$72.44	$112.20	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $34.67 / $61.66	Professional	26	$22.39	$34.67	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $77.62 / $138.04	Professional	TC	$50.12	$77.62	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $125.89	Professional		$79.43	$100.00	$125.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $29.51 / $38.02	Professional	26	$23.99	$29.51	$38.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $69.18 / $87.10	Professional	TC	$54.95	$69.18	$87.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $154.88	Professional		$109.65	$134.90	$154.88
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $52.48 / $58.88	Professional	26	$41.69	$52.48	$58.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $120.23 / $186.21	Facility		$81.28	$120.23	$186.21
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $144.54	Professional		$100.00	$100.00	$144.54
Sentara Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $89.13 / $190.55	Facility		$33.11	$89.13	$190.55
Sentara Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $107.15 / $338.84	Professional		$36.31	$107.15	$338.84
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $38.02 / $56.23	Professional	26	$29.51	$38.02	$56.23
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $91.20 / $134.90	Professional	TC	$61.66	$91.20	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $85.11 / $251.19	Facility		$38.90	$85.11	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $162.18	Professional		$70.79	$97.72	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.20 / $50.12	Professional	26	$21.88	$30.20	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $69.18 / $112.20	Professional	TC	$48.98	$69.18	$112.20