Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.56 / $72.59 / $292.44	Facility	26	$67.56	$72.59	$292.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.76 / $228.49 / $475.00	Professional		$190.76	$228.49	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.15 / $72.59 / $140.00	Professional	26	$63.15	$72.59	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.62 / $155.88 / $335.00	Professional	TC	$126.62	$155.88	$335.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.44 / $265.27 / $434.36	Professional		$207.44	$265.27	$434.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.03 / $87.98 / $134.75	Professional	26	$68.03	$87.98	$134.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.60 / $177.24 / $283.85	Professional	TC	$138.60	$177.24	$283.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $322.39 / $332.56 / $2,784.18	Professional		$322.39	$332.56	$2,784.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $86.32 / $86.32 / $120.85	Professional	26	$86.32	$86.32	$120.85
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $232.61 / $246.24 / $312.72	Professional	TC	$232.61	$246.24	$312.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.59 / $325.70 / $578.29	Professional		$205.59	$325.70	$578.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.22 / $99.52 / $168.78	Professional	26	$61.22	$99.52	$168.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.26 / $221.36 / $388.07	Professional	TC	$134.26	$221.36	$388.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $211.95 / $254.34 / $311.69	Professional		$211.95	$254.34	$311.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.75 / $81.30 / $100.84	Professional	26	$67.75	$81.30	$100.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.19 / $173.03 / $212.05	Professional	TC	$144.19	$173.03	$212.05
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $88.60 / $119.56 / $235.20	Facility	26	$88.60	$119.56	$235.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $132.86 / $286.00 / $459.00	Professional		$132.86	$286.00	$459.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $106.05 / $296.52 / $476.39	Professional		$106.05	$296.52	$476.39
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $81.58 / $106.87 / $169.31	Professional	26	$81.58	$106.87	$169.31
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $175.16 / $229.46 / $367.31	Professional	TC	$175.16	$229.46	$367.31
United Facility/Professional Professional Modifier Low / Median / High Price $202.76 / $385.10 / $1,307.58	Professional		$202.76	$385.10	$1,307.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.55 / $93.32 / $148.44	Professional	26	$58.55	$93.32	$148.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.87 / $266.97 / $1,094.17	Professional	TC	$138.87	$266.97	$1,094.17