Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $51.29 / $138.04	Facility	26	$30.20	$51.29	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $302.00 / $549.54	Professional		$251.19	$302.00	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $40.74 / $190.55	Professional	26	$30.20	$40.74	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $269.15 / $467.74	Professional	TC	$223.87	$269.15	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $389.05 / $588.84	Professional		$281.84	$389.05	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $43.65 / $67.61	Professional	26	$32.36	$43.65	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $512.86	Professional	TC	$251.19	$338.84	$512.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $501.19 / $741.31	Professional		$302.00	$501.19	$741.31
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $36.31 / $56.23	Professional	26	$33.11	$36.31	$56.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $295.12 / $457.09	Professional	TC	$269.15	$295.12	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $436.52 / $741.31	Professional		$263.03	$436.52	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $47.86 / $77.62	Professional	26	$28.18	$47.86	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $389.05 / $660.69	Professional	TC	$229.09	$389.05	$660.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $398.11 / $416.87	Professional		$281.84	$398.11	$416.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $45.71	Professional	26	$33.11	$43.65	$45.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $354.81 / $363.08	Professional	TC	$251.19	$354.81	$363.08
Medcost Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Sentara Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $389.05 / $2,511.89	Professional		$42.66	$389.05	$2,511.89
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $46.77 / $77.62	Professional	26	$34.67	$46.77	$77.62
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $371.54 / $645.65	Professional	TC	$288.40	$371.54	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $489.78 / $776.25	Professional		$269.15	$489.78	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $50.12 / $77.62	Professional	26	$29.51	$50.12	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $436.52 / $691.83	Professional	TC	$239.88	$436.52	$691.83