Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.47 / $77.11 / $261.70	Facility	26	$59.47	$77.11	$261.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $417.94 / $447.84 / $617.39	Professional		$417.94	$447.84	$617.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.47 / $65.16 / $110.96	Professional	26	$59.47	$65.16	$110.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $355.86 / $382.68 / $531.45	Professional	TC	$355.86	$382.68	$531.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $401.06 / $511.22 / $756.17	Professional		$401.06	$511.22	$756.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.84 / $76.86 / $113.80	Professional	26	$60.84	$76.86	$113.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $340.20 / $433.65 / $636.29	Professional	TC	$340.20	$433.65	$636.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $562.12 / $805.67 / $1,195.39	Professional		$562.12	$805.67	$1,195.39
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $80.77 / $100.96	Professional	26	$79.00	$80.77	$100.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $483.12 / $530.21 / $662.76	Professional	TC	$483.12	$530.21	$662.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $484.05 / $687.94 / $1,139.29	Professional		$484.05	$687.94	$1,139.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $95.00 / $149.93	Professional	26	$53.87	$95.00	$149.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $418.61 / $591.89 / $970.62	Professional	TC	$418.61	$591.89	$970.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $418.68 / $582.02 / $600.80	Professional		$418.68	$582.02	$600.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.14 / $84.22 / $87.73	Professional	26	$65.14	$84.22	$87.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $353.55 / $497.80 / $506.32	Professional	TC	$353.55	$497.80	$506.32
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $78.70 / $78.70 / $106.74	Facility	26	$78.70	$78.70	$106.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.91 / $668.12 / $911.00	Professional		$100.91	$668.12	$911.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $86.59 / $542.83 / $1,105.59	Professional		$86.59	$542.83	$1,105.59
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $73.26 / $95.97 / $151.97	Professional	26	$73.26	$95.97	$151.97
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $429.98 / $566.92 / $939.69	Professional	TC	$429.98	$566.92	$939.69
United Facility/Professional Professional Modifier Low / Median / High Price $402.68 / $707.64 / $1,122.28	Professional		$402.68	$707.64	$1,122.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.60 / $95.23 / $148.00	Professional	26	$58.60	$95.23	$148.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $344.08 / $585.29 / $867.19	Professional	TC	$344.08	$585.29	$867.19