Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.78 / $192.15 / $419.09	Facility		$34.78	$192.15	$419.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.79 / $13.86 / $34.03	Facility	26	$7.79	$13.86	$34.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.43 / $84.34 / $439.92	Facility	TC	$22.43	$84.34	$439.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.30 / $33.90 / $64.22	Professional		$29.30	$33.90	$64.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $11.28 / $22.94	Professional	26	$7.51	$11.28	$22.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $24.91 / $45.88	Professional	TC	$21.51	$24.91	$45.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.05 / $138.79 / $181.57	Facility		$110.05	$138.79	$181.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.46 / $40.40 / $62.30	Professional		$32.46	$40.40	$62.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $10.22 / $16.00	Professional	26	$7.81	$10.22	$16.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $30.61 / $44.75	Professional	TC	$22.74	$30.61	$44.75
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $41.65 / $111.38	Professional		$39.75	$41.65	$111.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $12.01 / $16.80	Professional	26	$11.40	$12.01	$16.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.23 / $27.74 / $34.68	Professional	TC	$27.23	$27.74	$34.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.91 / $109.17 / $500.00	Facility		$61.91	$109.17	$500.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $46.29 / $79.06	Professional		$28.98	$46.29	$79.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $13.43 / $24.50	Professional	26	$7.12	$13.43	$24.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $31.64 / $56.08	Professional	TC	$21.51	$31.64	$56.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $41.66 / $51.05	Professional		$34.71	$41.66	$51.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $9.69 / $11.69	Professional	26	$7.85	$9.69	$11.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.87 / $32.24 / $39.51	Professional	TC	$26.87	$32.24	$39.51
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.90 / $49.74 / $77.50	Facility		$33.90	$49.74	$77.50
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.28 / $20.00 / $34.65	Facility	26	$16.28	$20.00	$34.65
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $44.07 / $75.25	Facility	TC	$30.58	$44.07	$75.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $35.00 / $63.32	Professional		$16.00	$35.00	$63.32
Sentara Facility/Professional Facility Modifier Low / Median / High Price $13.11 / $34.34 / $63.91	Facility		$13.11	$34.34	$63.91
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.89 / $43.76 / $75.31	Professional		$15.89	$43.76	$75.31
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $15.42 / $21.29	Professional	26	$9.74	$15.42	$21.29
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $27.05 / $36.65 / $58.83	Professional	TC	$27.05	$36.65	$58.83
United Facility/Professional Facility Modifier Low / Median / High Price $187.24 / $207.51 / $495.91	Facility		$187.24	$207.51	$495.91
United Facility/Professional Professional Modifier Low / Median / High Price $28.25 / $42.91 / $68.95	Professional		$28.25	$42.91	$68.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $12.48 / $20.97	Professional	26	$8.18	$12.48	$20.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.85 / $30.43 / $47.99	Professional	TC	$19.85	$30.43	$47.99