Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.61 / $108.56 / $150.36	Professional		$88.61	$108.56	$150.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.05 / $79.18 / $109.45	Professional	26	$70.05	$79.18	$109.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $30.16 / $38.04	Professional	TC	$19.93	$30.16	$38.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.38 / $113.18 / $140.86	Professional		$91.38	$113.18	$140.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.23 / $82.07 / $99.93	Professional	26	$68.23	$82.07	$99.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.64 / $32.01 / $40.94	Professional	TC	$20.64	$32.01	$40.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $124.37 / $124.37 / $143.96	Professional		$124.37	$124.37	$143.96
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $87.48 / $87.48 / $106.68	Professional	26	$87.48	$87.48	$106.68
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $33.90 / $36.89 / $37.29	Professional	TC	$33.90	$36.89	$37.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.92 / $86.92 / $86.92	Facility	26	$86.92	$86.92	$86.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.49 / $116.28 / $241.06	Professional		$89.49	$116.28	$241.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.81 / $87.48 / $179.45	Professional	26	$68.81	$87.48	$179.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $28.76 / $62.64	Professional	TC	$19.80	$28.76	$62.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.53 / $106.49 / $137.40	Professional		$90.53	$106.49	$137.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.68 / $75.29 / $97.15	Professional	26	$65.68	$75.29	$97.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.86 / $31.19 / $39.90	Professional	TC	$24.86	$31.19	$39.90
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $81.59 / $82.13 / $148.03	Facility	26	$81.59	$82.13	$148.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $107.00 / $190.63	Professional		$28.00	$107.00	$190.63
Sentara Facility/Professional Professional Modifier Low / Median / High Price $22.40 / $101.51 / $162.71	Professional		$22.40	$101.51	$162.71
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $72.98 / $88.48 / $147.84	Professional	26	$72.98	$88.48	$147.84
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $17.86 / $27.86 / $51.79	Professional	TC	$17.86	$27.86	$51.79
United Facility/Professional Professional Modifier Low / Median / High Price $69.77 / $87.22 / $152.63	Professional		$69.77	$87.22	$152.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.75 / $66.59 / $114.80	Professional	26	$52.75	$66.59	$114.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.08 / $22.29 / $37.52	Professional	TC	$14.08	$22.29	$37.52