Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.21 / $353.88 / $605.01	Facility	26	$202.21	$353.88	$605.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $442.21 / $504.96 / $1,028.48	Professional		$442.21	$504.96	$1,028.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $221.36 / $419.05	Professional	26	$198.28	$221.36	$419.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.33 / $306.66 / $489.86	Professional	TC	$238.33	$306.66	$489.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $443.16 / $566.71 / $888.03	Professional		$443.16	$566.71	$888.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $205.90 / $262.45 / $395.32	Professional	26	$205.90	$262.45	$395.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.25 / $303.39 / $501.61	Professional	TC	$237.25	$303.39	$501.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $496.13 / $967.45 / $5,062.91	Professional		$496.13	$967.45	$5,062.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $243.62 / $244.63 / $244.63	Professional	26	$243.62	$244.63	$244.63
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $251.50 / $251.50 / $490.43	Professional	TC	$251.50	$251.50	$490.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.04 / $256.04 / $256.04	Facility	26	$256.04	$256.04	$256.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.96 / $769.04 / $1,565.29	Professional		$430.96	$769.04	$1,565.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $194.97 / $297.89 / $559.75	Professional	26	$194.97	$297.89	$559.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.43 / $421.26 / $1,270.97	Professional	TC	$229.43	$421.26	$1,270.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $478.60 / $646.91 / $679.54	Professional		$478.60	$646.91	$679.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $223.01 / $292.45 / $322.63	Professional	26	$223.01	$292.45	$322.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $255.58 / $356.90 / $365.72	Professional	TC	$255.58	$356.90	$365.72
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $326.64 / $440.00 / $666.85	Facility	26	$326.64	$440.00	$666.85
Medcost Facility/Professional Professional Modifier Low / Median / High Price $294.00 / $469.00 / $958.00	Professional		$294.00	$469.00	$958.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $271.66 / $658.47 / $4,839.00	Professional		$271.66	$658.47	$4,839.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $229.87 / $328.56 / $499.54	Professional	26	$229.87	$328.56	$499.54
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $287.01 / $409.56 / $1,030.29	Professional	TC	$287.01	$409.56	$1,030.29
United Facility/Professional Professional Modifier Low / Median / High Price $436.43 / $725.78 / $1,694.81	Professional		$436.43	$725.78	$1,694.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $184.99 / $277.49 / $417.27	Professional	26	$184.99	$277.49	$417.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.34 / $400.26 / $1,320.71	Professional	TC	$243.34	$400.26	$1,320.71