Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.61 / $81.51 / $514.12	Professional		$72.61	$81.51	$514.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $18.55 / $37.81	Professional	26	$16.71	$18.55	$37.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.85 / $63.31 / $99.90	Professional	TC	$55.85	$63.31	$99.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $34.85 / $72.72	Professional		$34.85	$34.85	$72.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $9.50 / $19.82	Professional	26	$9.50	$9.50	$19.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.34 / $25.34 / $52.87	Professional	TC	$25.34	$25.34	$52.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $96.76 / $96.76 / $113.21	Professional		$96.76	$96.76	$113.21
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $23.28 / $33.10	Professional	26	$23.28	$23.28	$33.10
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $73.48 / $73.48 / $85.97	Professional	TC	$73.48	$73.48	$85.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.27 / $54.34 / $151.26	Professional		$38.27	$54.34	$151.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.17 / $12.79 / $40.03	Professional	26	$9.17	$12.79	$40.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.00 / $39.47 / $117.47	Professional	TC	$27.00	$39.47	$117.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.84 / $106.81 / $140.25	Professional		$81.84	$106.81	$140.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $24.25 / $35.68	Professional	26	$18.64	$24.25	$35.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $63.19 / $84.38 / $104.56	Professional	TC	$63.19	$84.38	$104.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $38.00 / $41.35 / $67.00	Facility	26	$38.00	$41.35	$67.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $88.00 / $159.00	Professional		$29.00	$88.00	$159.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $33.19 / $107.58 / $187.76	Professional		$33.19	$107.58	$187.76
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $25.17 / $31.29 / $46.93	Professional	26	$25.17	$31.29	$46.93
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $62.97 / $108.67 / $173.60	Professional	TC	$62.97	$108.67	$173.60
United Facility/Professional Professional Modifier Low / Median / High Price $58.63 / $97.72 / $186.05	Professional		$58.63	$97.72	$186.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $22.72 / $41.40	Professional	26	$13.80	$22.72	$41.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.83 / $74.40 / $139.21	Professional	TC	$44.83	$74.40	$139.21