Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $512.86 / $851.14	Professional		$416.87	$512.86	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $100.00	Professional	26	$39.81	$47.86	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $457.09 / $776.25	Professional	TC	$380.19	$457.09	$776.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $537.03	Professional		$257.04	$257.04	$537.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $24.55 / $51.29	Professional	26	$24.55	$24.55	$51.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $234.42 / $489.78	Professional	TC	$234.42	$234.42	$489.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $489.78 / $575.44	Professional		$45.71	$489.78	$575.44
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $48.98 / $53.70	Professional	26	$48.98	$48.98	$53.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $446.68 / $501.19	Professional	TC	$446.68	$446.68	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $912.01	Professional		$263.03	$398.11	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $41.69 / $89.13	Professional	26	$26.30	$41.69	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $363.08 / $831.76	Professional	TC	$234.42	$363.08	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $691.83 / $794.33	Professional		$537.03	$691.83	$794.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $75.86	Professional	26	$53.70	$64.57	$75.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $616.60 / $724.44	Professional	TC	$478.63	$616.60	$724.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Sentara Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $512.86 / $891.25	Professional		$77.62	$512.86	$891.25
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $58.88 / $107.15	Professional	26	$51.29	$58.88	$107.15
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $512.86 / $977.24	Professional	TC	$398.11	$512.86	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $588.84 / $1,174.90	Professional		$346.74	$588.84	$1,174.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $60.26 / $120.23	Professional	26	$36.31	$60.26	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $524.81 / $1,047.13	Professional	TC	$316.23	$524.81	$1,047.13