Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.90 / $371.20 / $859.14	Facility		$112.90	$371.20	$859.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.03 / $40.85 / $74.84	Facility	26	$24.03	$40.85	$74.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $106.19 / $192.58	Professional		$75.17	$106.19	$192.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $25.28 / $51.00	Professional	26	$24.03	$25.28	$51.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.89 / $77.72 / $151.06	Professional	TC	$49.89	$77.72	$151.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $348.09 / $439.80 / $574.30	Facility		$348.09	$439.80	$574.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.94 / $136.37 / $187.56	Professional		$106.94	$136.37	$187.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $30.96 / $42.58	Professional	26	$24.28	$30.96	$42.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.67 / $105.42 / $144.99	Professional	TC	$82.67	$105.42	$144.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $131.05 / $176.67 / $262.12	Professional		$131.05	$176.67	$262.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $35.47 / $61.76	Professional	26	$31.67	$35.47	$61.76
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $92.06 / $103.11 / $179.52	Professional	TC	$92.06	$103.11	$179.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $750.00 / $750.00	Facility		$750.00	$750.00	$750.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $113.65 / $268.11	Professional		$79.81	$113.65	$268.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.63 / $34.60 / $68.29	Professional	26	$20.63	$34.60	$68.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.94 / $82.17 / $198.50	Professional	TC	$51.94	$82.17	$198.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.55 / $130.26 / $161.36	Professional		$108.55	$130.26	$161.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $30.29 / $37.36	Professional	26	$25.24	$30.29	$37.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $83.32 / $101.01 / $126.26	Professional	TC	$83.32	$101.01	$126.26
Medcost Facility/Professional Facility Modifier Low / Median / High Price $93.82 / $122.15 / $182.92	Facility		$93.82	$122.15	$182.92
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $42.56 / $64.68	Facility	26	$38.61	$42.56	$64.68
Medcost Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $81.00 / $190.40	Professional		$36.00	$81.00	$190.40
Sentara Facility/Professional Facility Modifier Low / Median / High Price $30.59 / $80.78 / $188.63	Facility		$30.59	$80.78	$188.63
Sentara Facility/Professional Professional Modifier Low / Median / High Price $32.60 / $97.10 / $239.32	Professional		$32.60	$97.10	$239.32
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $26.80 / $36.40 / $60.33	Professional	26	$26.80	$36.40	$60.33
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $53.10 / $96.94 / $188.63	Professional	TC	$53.10	$96.94	$188.63
United Facility/Professional Professional Modifier Low / Median / High Price $64.91 / $109.13 / $220.03	Professional		$64.91	$109.13	$220.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.69 / $32.07 / $51.41	Professional	26	$21.69	$32.07	$51.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.35 / $80.80 / $146.62	Professional	TC	$48.35	$80.80	$146.62