Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.98 / $95.09 / $116.00	Professional		$88.98	$95.09	$116.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.56 / $27.99 / $34.97	Professional	26	$25.56	$27.99	$34.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.28 / $66.43 / $82.69	Professional	TC	$64.28	$66.43	$82.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $44.64 / $93.15	Professional		$44.64	$44.64	$93.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.54 / $13.54 / $28.25	Professional	26	$13.54	$13.54	$28.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.10 / $31.10 / $64.89	Professional	TC	$31.10	$31.10	$64.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $114.00 / $135.94	Professional		$114.00	$114.00	$135.94
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.39 / $35.39 / $46.69	Professional	26	$35.39	$35.39	$46.69
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $78.61 / $78.61 / $91.97	Professional	TC	$78.61	$78.61	$91.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $70.65 / $198.51	Professional		$36.28	$70.65	$198.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $17.88 / $54.79	Professional	26	$12.43	$17.88	$54.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.84 / $51.22 / $147.11	Professional	TC	$23.84	$51.22	$147.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.03 / $162.54 / $185.09	Professional		$125.03	$162.54	$185.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.84 / $38.61 / $44.58	Professional	26	$31.84	$38.61	$44.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.18 / $121.13 / $141.19	Professional	TC	$93.18	$121.13	$141.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $36.81 / $92.46	Facility	26	$36.81	$36.81	$92.46
Medcost Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $94.34 / $226.22	Professional		$41.00	$94.34	$226.22
Sentara Facility/Professional Professional Modifier Low / Median / High Price $35.32 / $95.13 / $218.91	Professional		$35.32	$95.13	$218.91
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $39.34 / $70.42	Professional	26	$28.60	$39.34	$70.42
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $29.90 / $81.84 / $190.21	Professional	TC	$29.90	$81.84	$190.21
United Facility/Professional Professional Modifier Low / Median / High Price $55.97 / $104.54 / $174.86	Professional		$55.97	$104.54	$174.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $33.07 / $52.00	Professional	26	$17.39	$33.07	$52.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.58 / $71.47 / $121.93	Professional	TC	$38.58	$71.47	$121.93