Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.77 / $49.56 / $93.20	Facility	26	$41.77	$49.56	$93.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.19 / $351.41 / $427.54	Professional		$282.19	$351.41	$427.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $141.10 / $177.47 / $203.35	Professional	52	$141.10	$177.47	$203.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.80 / $305.67 / $370.67	Professional	TC	$247.80	$305.67	$370.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $313.14 / $428.91 / $663.80	Professional		$313.14	$428.91	$663.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $262.00 / $378.20 / $585.32	Professional	TC	$262.00	$378.20	$585.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $328.20 / $364.67 / $711.11	Professional		$328.20	$364.67	$711.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $291.08 / $323.43 / $630.69	Professional	TC	$291.08	$323.43	$630.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.73 / $454.90 / $803.58	Professional		$314.73	$454.90	$803.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.12 / $408.62 / $718.90	Professional	TC	$284.12	$408.62	$718.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $362.83 / $426.86 / $554.91	Professional		$362.83	$426.86	$554.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.36 / $49.86 / $61.74	Professional	26	$40.36	$49.86	$61.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $321.95 / $379.37 / $493.18	Professional	TC	$321.95	$379.37	$493.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $60.28 / $97.94 / $121.90	Facility	26	$60.28	$97.94	$121.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $59.00 / $400.00 / $639.00	Professional		$59.00	$400.00	$639.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $56.21 / $376.13 / $715.87	Professional		$56.21	$376.13	$715.87
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $287.80 / $406.78 / $698.15	Professional	TC	$287.80	$406.78	$698.15
United Facility/Professional Professional Modifier Low / Median / High Price $282.66 / $466.38 / $723.42	Professional		$282.66	$466.38	$723.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.49 / $403.26 / $666.85	Professional	TC	$229.49	$403.26	$666.85