Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.78 / $60.88 / $117.31	Professional		$50.78	$60.88	$117.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.13 / $22.84 / $62.84	Professional	26	$20.13	$22.84	$62.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.68 / $38.03 / $81.20	Professional	TC	$35.68	$38.03	$81.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.66 / $29.66 / $61.89	Professional		$29.66	$29.66	$61.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.94 / $10.94 / $22.82	Professional	26	$10.94	$10.94	$22.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.72 / $18.72 / $39.06	Professional	TC	$18.72	$18.72	$39.06
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $69.37 / $74.05 / $87.91	Professional		$69.37	$74.05	$87.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.69 / $22.82 / $30.59	Professional	26	$21.69	$22.82	$30.59
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $46.55 / $52.36 / $57.32	Professional	TC	$46.55	$52.36	$57.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.15 / $44.06 / $125.91	Professional		$27.15	$44.06	$125.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $15.03 / $48.22	Professional	26	$11.55	$15.03	$48.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.57 / $29.09 / $80.92	Professional	TC	$14.57	$29.09	$80.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.64 / $103.53 / $117.74	Professional		$79.64	$103.53	$117.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $31.32 / $39.58	Professional	26	$24.09	$31.32	$39.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $55.55 / $72.22 / $84.33	Professional	TC	$55.55	$72.22	$84.33
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $34.00 / $48.34 / $73.31	Facility	26	$34.00	$48.34	$73.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $58.70 / $121.00	Professional		$34.00	$58.70	$121.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $31.12 / $69.88 / $115.58	Professional		$31.12	$69.88	$115.58
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $28.26 / $45.44	Professional	26	$23.94	$28.26	$45.44
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $24.94 / $45.02 / $83.58	Professional	TC	$24.94	$45.02	$83.58
United Facility/Professional Professional Modifier Low / Median / High Price $36.35 / $71.62 / $116.06	Professional		$36.35	$71.62	$116.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $26.95 / $48.51	Professional	26	$16.17	$26.95	$48.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.04 / $39.65 / $72.75	Professional	TC	$18.04	$39.65	$72.75