Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.70 / $382.29 / $680.47	Professional		$316.70	$382.29	$680.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.07 / $41.61 / $61.18	Professional	26	$38.07	$41.61	$61.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $278.63 / $343.10 / $610.71	Professional	TC	$278.63	$343.10	$610.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.72 / $216.72 / $452.25	Professional		$216.72	$216.72	$452.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $20.88 / $43.57	Professional	26	$20.88	$20.88	$43.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.84 / $195.84 / $408.67	Professional	TC	$195.84	$195.84	$408.67
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $445.17 / $482.98 / $657.50	Professional		$445.17	$482.98	$657.50
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.83 / $42.56 / $58.09	Professional	26	$40.83	$42.56	$58.09
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $440.42 / $443.59 / $599.41	Professional	TC	$440.42	$443.59	$599.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.59 / $274.74 / $706.47	Professional		$188.59	$274.74	$706.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.81 / $26.98 / $75.87	Professional	26	$21.81	$26.98	$75.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.60 / $248.98 / $624.10	Professional	TC	$165.60	$248.98	$624.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $387.33 / $510.91 / $725.62	Professional		$387.33	$510.91	$725.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.31 / $58.90 / $74.86	Professional	26	$45.31	$58.90	$74.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $342.01 / $455.92 / $650.76	Professional	TC	$342.01	$455.92	$650.76
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $93.00 / $93.00 / $138.25	Facility	26	$93.00	$93.00	$138.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $613.00 / $989.64	Professional		$65.00	$613.00	$989.64
Sentara Facility/Professional Professional Modifier Low / Median / High Price $63.89 / $437.53 / $656.58	Professional		$63.89	$437.53	$656.58
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $45.98 / $50.69 / $85.98	Professional	26	$45.98	$50.69	$85.98
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $331.20 / $395.79 / $680.55	Professional	TC	$331.20	$395.79	$680.55
United Facility/Professional Professional Modifier Low / Median / High Price $267.94 / $481.91 / $861.11	Professional		$267.94	$481.91	$861.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.41 / $50.69 / $93.58	Professional	26	$30.41	$50.69	$93.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $237.53 / $439.46 / $757.49	Professional	TC	$237.53	$439.46	$757.49