Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $794.33	Professional		$56.23	$104.71	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $109.65 / $616.60	Professional	26	$21.88	$109.65	$616.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $70.79 / $177.83	Professional	TC	$34.67	$70.79	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $29.51 / $63.10	Professional		$29.51	$29.51	$63.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.02 / $26.30	Professional	26	$12.02	$12.02	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $17.38 / $38.02	Professional	TC	$17.38	$17.38	$38.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $107.15 / $125.89	Professional		$28.84	$107.15	$125.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $27.54	Professional	26	$25.70	$25.70	$27.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $91.20 / $97.72	Professional	TC	$87.10	$91.20	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $58.88 / $154.88	Professional		$34.67	$58.88	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $15.85 / $46.77	Professional	26	$13.18	$15.85	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $43.65 / $114.82	Professional	TC	$20.89	$43.65	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $154.88	Professional		$104.71	$134.90	$154.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.11 / $38.02	Professional	26	$26.92	$33.11	$38.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $102.33 / $117.49	Professional	TC	$77.62	$102.33	$117.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Sentara Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $93.33 / $218.78	Professional		$42.66	$93.33	$218.78
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $41.69 / $64.57	Professional	26	$32.36	$41.69	$64.57
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $100.00 / $177.83	Professional	TC	$50.12	$100.00	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $154.88	Professional		$54.95	$81.28	$154.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $29.51 / $58.88	Professional	26	$18.20	$29.51	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $51.29 / $102.33	Professional	TC	$34.67	$51.29	$102.33