Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.64 / $105.20 / $257.27	Professional		$73.64	$105.20	$257.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $37.47 / $101.36	Professional	26	$25.75	$37.47	$101.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.21 / $71.28 / $121.17	Professional	TC	$50.21	$71.28	$121.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $54.58 / $114.72	Professional		$54.58	$54.58	$114.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.42 / $46.05	Professional	26	$20.42	$20.42	$46.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $35.86 / $74.83	Professional	TC	$35.86	$35.86	$74.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $126.08 / $126.08 / $168.36	Professional		$126.08	$126.08	$168.36
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $45.99 / $45.99 / $65.45	Professional	26	$45.99	$45.99	$65.45
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $80.09 / $80.09 / $102.91	Professional	TC	$80.09	$80.09	$102.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.37 / $74.52 / $201.44	Professional		$55.37	$74.52	$201.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.67 / $28.56 / $98.58	Professional	26	$18.67	$28.56	$98.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.90 / $47.52 / $133.94	Professional	TC	$33.90	$47.52	$133.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.98 / $148.16 / $208.02	Professional		$113.98	$148.16	$208.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $50.21 / $80.84	Professional	26	$38.61	$50.21	$80.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $75.36 / $100.51 / $124.74	Professional	TC	$75.36	$100.51	$124.74
Medcost Facility/Professional Facility Modifier Low / Median / High Price $111.51 / $166.32 / $264.20	Facility		$111.51	$166.32	$264.20
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $64.00 / $100.34 / $124.92	Facility	26	$64.00	$100.34	$124.92
Medcost Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $110.00 / $213.00	Professional		$70.00	$110.00	$213.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $58.56 / $97.52 / $194.72	Facility		$58.56	$97.52	$194.72
Sentara Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $147.24 / $235.05	Professional		$68.00	$147.24	$235.05
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $51.65 / $67.73 / $91.62	Professional	26	$51.65	$67.73	$91.62
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $68.36 / $112.46 / $185.24	Professional	TC	$68.36	$112.46	$185.24
United Facility/Professional Professional Modifier Low / Median / High Price $75.88 / $126.46 / $208.73	Professional		$75.88	$126.46	$208.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.33 / $44.03 / $88.60	Professional	26	$26.33	$44.03	$88.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $70.81 / $133.38	Professional	TC	$36.22	$70.81	$133.38