Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.77 / $74.52 / $173.71	Facility	26	$47.77	$74.52	$173.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.89 / $305.10 / $567.44	Professional		$282.89	$305.10	$567.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.47 / $47.77 / $95.84	Professional	26	$43.47	$47.77	$95.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.60 / $257.33 / $524.96	Professional	TC	$237.60	$257.33	$524.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $273.58 / $348.15 / $490.48	Professional		$273.58	$348.15	$490.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.19 / $56.23 / $79.23	Professional	26	$44.19	$56.23	$79.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.39 / $291.91 / $411.25	Professional	TC	$229.39	$291.91	$411.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $352.06 / $696.93 / $1,053.66	Professional		$352.06	$696.93	$1,053.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.40 / $54.40 / $68.00	Professional	26	$54.40	$54.40	$68.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $297.66 / $297.66 / $372.08	Professional	TC	$297.66	$297.66	$372.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.14 / $440.66 / $758.06	Professional		$267.14	$440.66	$758.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $69.02 / $109.81	Professional	26	$40.11	$69.02	$109.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.80 / $371.64 / $644.77	Professional	TC	$222.80	$371.64	$644.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $291.91 / $405.65 / $418.83	Professional		$291.91	$405.65	$418.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.12 / $62.38 / $64.98	Professional	26	$48.12	$62.38	$64.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $243.80 / $343.27 / $349.09	Professional	TC	$243.80	$343.27	$349.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $397.00 / $643.00	Professional		$67.00	$397.00	$643.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $62.32 / $383.30 / $2,001.00	Professional		$62.32	$383.30	$2,001.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $49.31 / $68.23 / $111.11	Professional	26	$49.31	$68.23	$111.11
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $265.45 / $378.20 / $627.86	Professional	TC	$265.45	$378.20	$627.86
United Facility/Professional Professional Modifier Low / Median / High Price $245.06 / $450.42 / $693.06	Professional		$245.06	$450.42	$693.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $66.92 / $106.87	Professional	26	$42.78	$66.92	$106.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $230.20 / $396.01 / $613.08	Professional	TC	$230.20	$396.01	$613.08