Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.96 / $92.88 / $116.42	Facility	26	$61.96	$92.88	$116.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $451.00 / $770.42	Professional		$338.67	$451.00	$770.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.92 / $57.71 / $102.57	Professional	26	$48.92	$57.71	$102.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $389.04 / $665.80	Professional	TC	$287.33	$389.04	$665.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $369.70 / $516.85 / $804.74	Professional		$369.70	$516.85	$804.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.20 / $64.56 / $107.66	Professional	26	$50.20	$64.56	$107.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $311.98 / $455.56 / $706.29	Professional	TC	$311.98	$455.56	$706.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $405.66 / $450.73 / $878.92	Professional		$405.66	$450.73	$878.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $53.71 / $104.73	Professional	26	$53.71	$53.71	$104.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $397.02 / $397.02 / $774.19	Professional	TC	$397.02	$397.02	$774.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.07 / $539.13 / $987.34	Professional		$215.07	$539.13	$987.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $75.78 / $130.91	Professional	26	$53.67	$75.78	$130.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.61 / $468.51 / $873.80	Professional	TC	$158.61	$468.51	$873.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $439.36 / $516.89 / $671.96	Professional		$439.36	$516.89	$671.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.37 / $62.22 / $77.04	Professional	26	$50.37	$62.22	$77.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $388.38 / $457.63 / $594.91	Professional	TC	$388.38	$457.63	$594.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $56.27 / $73.00 / $147.38	Facility	26	$56.27	$73.00	$147.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $408.00 / $778.94	Professional		$75.00	$408.00	$778.94
Sentara Facility/Professional Professional Modifier Low / Median / High Price $74.59 / $451.77 / $873.25	Professional		$74.59	$451.77	$873.25
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $56.42 / $79.66 / $127.44	Professional	26	$56.42	$79.66	$127.44
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $334.08 / $529.16 / $878.76	Professional	TC	$334.08	$529.16	$878.76
United Facility/Professional Professional Modifier Low / Median / High Price $190.30 / $454.15 / $851.70	Professional		$190.30	$454.15	$851.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.47 / $76.59 / $117.56	Professional	26	$45.47	$76.59	$117.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.37 / $396.37 / $802.55	Professional	TC	$131.37	$396.37	$802.55