Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $190.55 / $588.84	Facility		$42.66	$190.55	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $12.59 / $34.67	Facility	26	$7.76	$12.59	$34.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.98 / $269.15 / $549.54	Facility	TC	$16.98	$269.15	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.84 / $81.28	Professional		$17.78	$28.84	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $34.67	Professional	26	$7.94	$9.12	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $16.98 / $34.67	Professional	TC	$10.96	$16.98	$34.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $104.71 / $131.83	Facility		$89.13	$104.71	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $50.12	Professional		$23.44	$32.36	$50.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $16.60	Professional	26	$7.94	$10.96	$16.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $33.88	Professional	TC	$15.14	$21.88	$33.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $29.51 / $245.47	Professional		$8.32	$29.51	$245.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $13.18 / $14.13	Professional	26	$11.75	$13.18	$14.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $19.95 / $28.18	Professional	TC	$18.20	$19.95	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $69.18 / $524.81	Facility		$40.74	$69.18	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.07 / $19.05 / $26.92	Facility	TC	$4.07	$19.05	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $26.92 / $53.70	Professional		$18.62	$26.92	$53.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.96 / $19.05	Professional	26	$6.76	$10.96	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $15.14 / $35.48	Professional	TC	$10.47	$15.14	$35.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $29.51 / $37.15	Professional		$24.55	$29.51	$37.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.55 / $11.75	Professional	26	$7.76	$9.55	$11.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.42 / $25.12	Professional	TC	$16.60	$20.42	$25.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $18.20	Professional	26	$18.20	$18.20	$18.20
Medcost Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $30.20 / $46.77	Facility		$20.89	$30.20	$46.77
Medcost Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $17.38 / $41.69	Professional		$17.38	$17.38	$41.69
Sentara Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $19.50 / $51.29	Facility		$10.23	$19.50	$51.29
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $23.99 / $85.11	Professional		$10.72	$23.99	$85.11
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.48 / $19.50	Professional	26	$8.91	$11.48	$19.50
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $17.38 / $37.15	Professional	TC	$10.72	$17.38	$37.15
United Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $17.78 / $186.21	Facility		$8.32	$17.78	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $25.70 / $46.77	Professional		$17.38	$25.70	$46.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.23 / $18.62	Professional	26	$6.76	$10.23	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $16.22 / $29.51	Professional	TC	$9.77	$16.22	$29.51