Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $162.18 / $371.54	Facility	26	$83.18	$162.18	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $251.19	Professional		$120.23	$144.54	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $53.70 / $97.72	Professional	TC	$41.69	$53.70	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $281.84	Professional		$134.90	$190.55	$281.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $70.79 / $100.00	Professional	TC	$48.98	$70.79	$100.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $223.87 / $776.25	Professional		$109.65	$223.87	$776.25
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $61.66 / $125.89	Professional	TC	$56.23	$61.66	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $208.93 / $380.19	Professional		$120.23	$208.93	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $74.13 / $138.04	Professional	TC	$43.65	$74.13	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $190.55 / $199.53	Professional		$141.25	$190.55	$199.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $117.49 / $123.03	Professional	26	$89.13	$117.49	$123.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $70.79 / $77.62	Professional	TC	$53.70	$70.79	$77.62
Medcost Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $309.03 / $331.13	Professional		$263.03	$309.03	$331.13
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $151.36 / $177.83	Professional	26	$138.04	$151.36	$177.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Sentara Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $169.82 / $398.11	Professional		$61.66	$169.82	$398.11
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $79.43 / $128.82	Professional	TC	$53.70	$79.43	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $194.98 / $331.13	Professional		$120.23	$194.98	$331.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $70.79 / $138.04	Professional	TC	$44.67	$70.79	$138.04