Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.13 / $150.32 / $295.23	Facility	26	$83.13	$150.32	$295.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.85 / $135.80 / $259.14	Professional		$127.85	$135.80	$259.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.25 / $52.67 / $92.77	Professional	TC	$44.25	$52.67	$92.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.08 / $167.58 / $237.93	Professional		$131.08	$167.58	$237.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.40 / $61.59 / $86.77	Professional	TC	$48.40	$61.59	$86.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $180.53 / $236.26 / $753.67	Professional		$180.53	$236.26	$753.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $67.97 / $70.26 / $124.86	Professional	TC	$67.97	$70.26	$124.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.07 / $106.07 / $106.07	Facility	26	$106.07	$106.07	$106.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.19 / $206.76 / $372.46	Professional		$122.19	$206.76	$372.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.54 / $74.56 / $136.04	Professional	TC	$43.54	$74.56	$136.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.91 / $189.79 / $199.36	Professional		$142.91	$189.79	$199.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $90.04 / $116.92 / $121.79	Professional	26	$90.04	$116.92	$121.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.88 / $73.84 / $75.63	Professional	TC	$52.88	$73.84	$75.63
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $145.83 / $156.43 / $289.37	Facility	26	$145.83	$156.43	$289.37
Medcost Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $140.00 / $262.00	Professional		$68.00	$140.00	$262.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $174.16 / $333.04	Professional		$63.88	$174.16	$333.04
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $54.33 / $80.22 / $125.78	Professional	TC	$54.33	$80.22	$125.78
United Facility/Professional Professional Modifier Low / Median / High Price $121.28 / $197.08 / $323.00	Professional		$121.28	$197.08	$323.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.24 / $70.05 / $119.46	Professional	TC	$44.24	$70.05	$119.46