Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $112.20 / $302.00	Facility	26	$66.07	$112.20	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $489.78 / $2,089.30	Professional		$371.54	$489.78	$2,089.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $77.62 / $204.17	Professional	26	$64.57	$77.62	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $371.54 / $870.96	Professional	TC	$302.00	$371.54	$870.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $549.54 / $851.14	Professional		$407.38	$549.54	$851.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $95.50 / $144.54	Professional	26	$69.18	$95.50	$144.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $457.09 / $691.83	Professional	TC	$331.13	$457.09	$691.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $501.19 / $1,995.26	Professional		$79.43	$501.19	$1,995.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $89.13 / $138.04	Professional	26	$75.86	$89.13	$138.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $446.68 / $616.60	Professional	TC	$398.11	$446.68	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $616.60 / $1,000.00	Professional		$380.19	$616.60	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $107.15 / $162.18	Professional	26	$60.26	$107.15	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $501.19 / $831.76	Professional	TC	$316.23	$501.19	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $588.84 / $616.60	Professional		$426.58	$588.84	$616.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $95.50 / $102.33	Professional	26	$74.13	$95.50	$102.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $501.19 / $512.86	Professional	TC	$354.81	$501.19	$512.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $537.03 / $912.01	Professional		$478.63	$537.03	$912.01
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $112.20 / $151.36	Professional	26	$107.15	$112.20	$151.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Sentara Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $524.81 / $3,715.35	Professional		$93.33	$524.81	$3,715.35
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $102.33 / $169.82	Professional	26	$75.86	$102.33	$169.82
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $501.19 / $891.25	Professional	TC	$281.84	$501.19	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $707.95 / $1,122.02	Professional		$416.87	$707.95	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $120.23 / $199.53	Professional	26	$72.44	$120.23	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $588.84 / $933.25	Professional	TC	$346.74	$588.84	$933.25