Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.21 / $343.75 / $649.49	Facility	26	$202.21	$343.75	$649.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $427.44 / $449.15 / $906.87	Professional		$427.44	$449.15	$906.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $188.34 / $215.06 / $411.65	Professional	26	$188.34	$215.06	$411.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $235.68 / $245.27 / $495.21	Professional	TC	$235.68	$245.27	$495.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $432.10 / $542.94 / $757.83	Professional		$432.10	$542.94	$757.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $206.21 / $262.85 / $374.39	Professional	26	$206.21	$262.85	$374.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.24 / $283.83 / $396.17	Professional	TC	$223.24	$283.83	$396.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $566.44 / $566.44 / $1,181.19	Professional		$566.44	$566.44	$1,181.19
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $230.12 / $230.12 / $230.12	Professional	26	$230.12	$230.12	$230.12
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $336.32 / $336.32 / $336.32	Professional	TC	$336.32	$336.32	$336.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.39 / $256.39 / $256.39	Facility	26	$256.39	$256.39	$256.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.02 / $656.06 / $1,212.15	Professional		$425.02	$656.06	$1,212.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $191.59 / $298.33 / $555.75	Professional	26	$191.59	$298.33	$555.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $214.68 / $344.20 / $644.32	Professional	TC	$214.68	$344.20	$644.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $468.07 / $632.22 / $664.10	Professional		$468.07	$632.22	$664.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $223.01 / $292.45 / $304.64	Professional	26	$223.01	$292.45	$304.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.05 / $342.21 / $350.54	Professional	TC	$245.05	$342.21	$350.54
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $319.02 / $321.81 / $666.85	Facility	26	$319.02	$321.81	$666.85
Medcost Facility/Professional Professional Modifier Low / Median / High Price $288.00 / $421.00 / $785.00	Professional		$288.00	$421.00	$785.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $247.00 / $552.19 / $7,473.00	Professional		$247.00	$552.19	$7,473.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $217.33 / $309.82 / $490.57	Professional	26	$217.33	$309.82	$490.57
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $237.50 / $352.00 / $549.25	Professional	TC	$237.50	$352.00	$549.25
United Facility/Professional Professional Modifier Low / Median / High Price $394.80 / $603.05 / $942.72	Professional		$394.80	$603.05	$942.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $184.99 / $281.38 / $418.78	Professional	26	$184.99	$281.38	$418.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.81 / $340.94 / $528.78	Professional	TC	$209.81	$340.94	$528.78