Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.15 / $41.26 / $149.77	Facility	26	$35.15	$41.26	$149.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.70 / $273.08 / $382.75	Professional		$234.70	$273.08	$382.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.15 / $38.88 / $53.98	Professional	26	$35.15	$38.88	$53.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.43 / $236.99 / $328.97	Professional	TC	$198.43	$236.99	$328.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.34 / $292.00 / $403.01	Professional		$228.34	$292.00	$403.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $43.07 / $60.20	Professional	26	$34.11	$43.07	$60.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.23 / $248.38 / $342.81	Professional	TC	$194.23	$248.38	$342.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $261.67 / $291.08 / $652.51	Professional		$261.67	$291.08	$652.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $34.95 / $66.06	Professional	26	$34.95	$34.95	$66.06
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $226.72 / $226.72 / $428.50	Professional	TC	$226.72	$226.72	$428.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.63 / $343.34 / $595.20	Professional		$242.63	$343.34	$595.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.60 / $49.78 / $86.93	Professional	26	$36.60	$49.78	$86.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.04 / $293.64 / $508.27	Professional	TC	$205.04	$293.64	$508.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.10 / $292.63 / $346.47	Professional		$234.10	$292.63	$346.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $41.98 / $49.98	Professional	26	$33.97	$41.98	$49.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $198.63 / $248.29 / $293.97	Professional	TC	$198.63	$248.29	$293.97
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $45.32 / $46.06 / $101.71	Facility	26	$45.32	$46.06	$101.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $318.00 / $496.10	Professional		$53.00	$318.00	$496.10
Sentara Facility/Professional Professional Modifier Low / Median / High Price $50.33 / $313.81 / $553.87	Professional		$50.33	$313.81	$553.87
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $41.70 / $53.10 / $84.54	Professional	26	$41.70	$53.10	$84.54
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $243.61 / $307.95 / $508.92	Professional	TC	$243.61	$307.95	$508.92
United Facility/Professional Professional Modifier Low / Median / High Price $215.35 / $340.17 / $571.16	Professional		$215.35	$340.17	$571.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.46 / $47.13 / $77.13	Professional	26	$31.46	$47.13	$77.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.89 / $289.01 / $448.81	Professional	TC	$183.89	$289.01	$448.81