Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.15 / $128.44 / $241.20	Facility	26	$109.15	$128.44	$241.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $336.22 / $411.52 / $533.19	Professional	TC	$336.22	$411.52	$533.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $351.96 / $505.91 / $782.99	Professional	TC	$351.96	$505.91	$782.99
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $394.88 / $438.76 / $855.58	Professional	TC	$394.88	$438.76	$855.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $384.50 / $555.44 / $967.04	Professional	TC	$384.50	$555.44	$967.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $105.64 / $130.49 / $161.56	Professional	26	$105.64	$130.49	$161.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $427.28 / $503.52 / $654.58	Professional	TC	$427.28	$503.52	$654.58
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $157.75 / $255.63 / $316.20	Facility	26	$157.75	$255.63	$316.20
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $390.84 / $551.95 / $948.00	Professional	TC	$390.84	$551.95	$948.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $314.67 / $539.40 / $890.56	Professional	TC	$314.67	$539.40	$890.56