Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.53 / $62.33 / $116.42	Facility	26	$52.53	$62.33	$116.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $407.00 / $696.55	Professional		$316.31	$407.00	$696.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $264.98 / $344.67 / $589.86	Professional	TC	$264.98	$344.67	$589.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.18 / $463.97 / $731.05	Professional		$332.18	$463.97	$731.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.51 / $401.48 / $632.59	Professional	TC	$263.51	$401.48	$632.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $403.39 / $419.57 / $818.16	Professional		$403.39	$419.57	$818.16
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $349.68 / $365.86 / $713.43	Professional	TC	$349.68	$365.86	$713.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.04 / $490.68 / $917.10	Professional		$274.04	$490.68	$917.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.43 / $421.39 / $803.68	Professional	TC	$203.43	$421.39	$803.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $405.93 / $477.86 / $620.84	Professional		$405.93	$477.86	$620.84
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 $354.97 / $418.31 / $543.79	Professional	TC	$354.97	$418.31	$543.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $55.81 / $73.00 / $147.38	Facility	26	$55.81	$73.00	$147.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $389.00 / $718.00	Professional		$75.00	$389.00	$718.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $75.05 / $400.56 / $819.73	Professional		$75.05	$400.56	$819.73
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $291.61 / $469.81 / $784.01	Professional	TC	$291.61	$469.81	$784.01
United Facility/Professional Professional Modifier Low / Median / High Price $227.76 / $436.33 / $857.52	Professional		$227.76	$436.33	$857.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.82 / $371.21 / $657.03	Professional	TC	$150.82	$371.21	$657.03