Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.36 / $188.92 / $529.19	Facility		$47.36	$188.92	$529.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.79 / $12.70 / $62.77	Facility	26	$7.79	$12.70	$62.77
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.66 / $301.77 / $543.55	Facility	TC	$21.66	$301.77	$543.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $22.59 / $42.34	Professional		$17.78	$22.59	$42.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $8.63 / $15.14	Professional	26	$7.51	$8.63	$15.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $14.71 / $29.10	Professional	TC	$10.66	$14.71	$29.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.13 / $99.80 / $130.56	Facility		$79.13	$99.80	$130.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.55 / $28.77 / $43.26	Professional		$21.55	$28.77	$43.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $9.61 / $14.58	Professional	26	$7.51	$9.61	$14.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.32 / $19.41 / $28.38	Professional	TC	$14.32	$19.41	$28.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $29.19 / $244.25	Professional		$27.72	$29.19	$244.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.01 / $10.26 / $13.03	Professional	26	$10.01	$10.26	$13.03
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $17.46 / $17.46 / $21.83	Professional	TC	$17.46	$17.46	$21.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.32 / $69.56 / $750.00	Facility		$32.32	$69.56	$750.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.88 / $27.45 / $54.01	Professional		$18.88	$27.45	$54.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $11.10 / $19.09	Professional	26	$6.81	$11.10	$19.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.67 / $15.19 / $35.04	Professional	TC	$10.67	$15.19	$35.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $29.86 / $36.59	Professional		$24.88	$29.86	$36.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $9.69 / $11.63	Professional	26	$7.85	$9.69	$11.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.03 / $20.44 / $25.05	Professional	TC	$17.03	$20.44	$25.05
Medcost Facility/Professional Facility Modifier Low / Median / High Price $22.17 / $28.65 / $43.82	Facility		$22.17	$28.65	$43.82
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.37 / $20.63 / $26.90	Facility	26	$13.37	$20.63	$26.90
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $14.58 / $14.96 / $29.91	Facility	TC	$14.58	$14.96	$29.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $26.09 / $47.00	Professional		$13.00	$26.09	$47.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $10.62 / $19.64 / $41.77	Facility		$10.62	$19.64	$41.77
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.57 / $25.02 / $53.55	Professional		$11.57	$25.02	$53.55
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $12.40 / $19.64	Professional	26	$9.30	$12.40	$19.64
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $11.89 / $19.70 / $35.79	Professional	TC	$11.89	$19.70	$35.79
United Facility/Professional Facility Modifier Low / Median / High Price $49.69 / $185.87 / $185.87	Facility		$49.69	$185.87	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $18.45 / $28.17 / $50.27	Professional		$18.45	$28.17	$50.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.04 / $11.20 / $17.71	Professional	26	$7.04	$11.20	$17.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.36 / $16.60 / $28.32	Professional	TC	$10.36	$16.60	$28.32