Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.21 / $74.33 / $126.36	Professional		$42.21	$74.33	$126.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $22.40 / $60.80	Professional	26	$9.84	$22.40	$60.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.40 / $64.48 / $129.96	Professional	TC	$46.40	$64.48	$129.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $28.80 / $60.22	Professional		$28.80	$28.80	$60.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $5.04 / $11.36	Professional	26	$5.04	$5.04	$11.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $23.76 / $49.58	Professional	TC	$23.76	$23.76	$49.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $73.41 / $73.41 / $85.89	Professional		$73.41	$73.41	$85.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.48 / $13.48 / $17.55	Professional	26	$13.48	$13.48	$17.55
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $59.93 / $59.93 / $68.20	Professional	TC	$59.93	$59.93	$68.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.31 / $48.87 / $134.74	Professional		$32.31	$48.87	$134.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.48 / $6.90 / $23.54	Professional	26	$5.48	$6.90	$23.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $41.43 / $114.98	Professional	TC	$27.17	$41.43	$114.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.29 / $103.17 / $117.24	Professional		$78.29	$103.17	$117.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $14.57 / $18.93	Professional	26	$11.21	$14.57	$18.93
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.09 / $89.49 / $101.69	Professional	TC	$67.09	$89.49	$101.69
Medcost Facility/Professional Facility Modifier Low / Median / High Price $59.46 / $94.78 / $134.22	Facility		$59.46	$94.78	$134.22
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.00 / $26.93 / $39.00	Facility	26	$21.00	$26.93	$39.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $132.66 / $132.66 / $166.86	Facility	TC	$132.66	$132.66	$166.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $76.00 / $138.63	Professional		$16.00	$76.00	$138.63
Sentara Facility/Professional Facility Modifier Low / Median / High Price $14.65 / $68.08 / $148.66	Facility		$14.65	$68.08	$148.66
Sentara Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $87.84 / $154.03	Professional		$17.00	$87.84	$154.03
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.99 / $17.11 / $26.47	Professional	26	$11.99	$17.11	$26.47
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $56.09 / $94.07 / $150.19	Professional	TC	$56.09	$94.07	$150.19
United Facility/Professional Professional Modifier Low / Median / High Price $41.67 / $76.55 / $123.57	Professional		$41.67	$76.55	$123.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $12.56 / $24.02	Professional	26	$7.54	$12.56	$24.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $60.95 / $114.97	Professional	TC	$32.90	$60.95	$114.97