Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.52 / $402.51 / $926.96	Professional		$313.52	$402.51	$926.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $164.00 / $183.39 / $311.76	Professional	26	$164.00	$183.39	$311.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.53 / $217.32 / $605.44	Professional	TC	$149.53	$217.32	$605.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.81 / $173.81 / $392.02	Professional		$173.81	$173.81	$392.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $74.73 / $155.96	Professional	26	$74.73	$74.73	$155.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.07 / $99.07 / $206.73	Professional	TC	$99.07	$99.07	$206.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $364.61 / $364.61 / $463.05	Professional		$364.61	$364.61	$463.05
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $193.04 / $193.04 / $245.16	Professional	26	$193.04	$193.04	$245.16
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $171.57 / $171.57 / $217.89	Professional	TC	$171.57	$171.57	$217.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $440.43	Professional		$326.16	$326.16	$440.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $350.27 / $455.35 / $772.90	Professional		$350.27	$455.35	$772.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $215.75 / $303.33	Professional	26	$165.96	$215.75	$303.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $184.31 / $245.96 / $424.84	Professional	TC	$184.31	$245.96	$424.84
Medcost Facility/Professional Facility Modifier Low / Median / High Price $305.95 / $538.47 / $1,316.23	Facility		$305.95	$538.47	$1,316.23
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $326.89 / $326.89 / $407.79	Facility	26	$326.89	$326.89	$407.79
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $339.41 / $411.87 / $411.87	Facility	TC	$339.41	$411.87	$411.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $279.47 / $372.16 / $733.00	Professional		$279.47	$372.16	$733.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $191.33 / $373.71 / $671.57	Facility		$191.33	$373.71	$671.57
Sentara Facility/Professional Professional Modifier Low / Median / High Price $232.66 / $569.35 / $817.97	Professional		$232.66	$569.35	$817.97
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $182.22 / $263.00 / $407.17	Professional	26	$182.22	$263.00	$407.17
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $236.49 / $308.83 / $457.37	Professional	TC	$236.49	$308.83	$457.37
United Facility/Professional Professional Modifier Low / Median / High Price $207.40 / $481.79 / $926.08	Professional		$207.40	$481.79	$926.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.89 / $168.51 / $374.28	Professional	26	$110.89	$168.51	$374.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.51 / $324.80 / $651.24	Professional	TC	$96.51	$324.80	$651.24