Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.88 / $208.16 / $581.88	Facility		$68.88	$208.16	$581.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.26 / $15.74 / $70.69	Facility	26	$9.26	$15.74	$70.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.25 / $296.38 / $532.91	Facility	TC	$32.25	$296.38	$532.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.39 / $56.92	Professional		$27.54	$30.39	$56.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $10.19 / $20.30	Professional	26	$8.93	$10.19	$20.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $21.27 / $40.29	Professional	TC	$17.92	$21.27	$40.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.67 / $129.47 / $169.39	Facility		$102.67	$129.47	$169.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.03 / $38.74 / $58.05	Professional		$29.03	$38.74	$58.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $11.96 / $18.45	Professional	26	$9.31	$11.96	$18.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.51 / $26.50 / $40.21	Professional	TC	$19.51	$26.50	$40.21
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $38.03 / $244.25	Professional		$35.22	$38.03	$244.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $12.20 / $15.49	Professional	26	$12.20	$12.20	$15.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.03 / $23.03 / $28.79	Professional	TC	$23.03	$23.03	$28.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.60 / $93.71 / $750.00	Facility		$43.60	$93.71	$750.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.05 / $39.67 / $69.68	Professional		$26.05	$39.67	$69.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $13.51 / $22.74	Professional	26	$8.41	$13.51	$22.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.79 / $24.98 / $47.45	Professional	TC	$17.79	$24.98	$47.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.27 / $38.72 / $47.46	Professional		$32.27	$38.72	$47.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.53 / $13.89	Professional	26	$9.33	$11.53	$13.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.93 / $27.52 / $33.72	Professional	TC	$22.93	$27.52	$33.72
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.20 / $42.77 / $56.93	Facility		$28.20	$42.77	$56.93
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.16 / $18.92 / $32.15	Facility	26	$12.16	$18.92	$32.15
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.89 / $27.53 / $53.66	Facility	TC	$26.89	$27.53	$53.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $15.63 / $35.15 / $60.00	Professional		$15.63	$35.15	$60.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $13.20 / $28.84 / $56.25	Facility		$13.20	$28.84	$56.25
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $37.01 / $72.30	Professional		$14.53	$37.01	$72.30
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $14.79 / $23.42	Professional	26	$11.09	$14.79	$23.42
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $30.14 / $49.38	Professional	TC	$21.78	$30.14	$49.38
United Facility/Professional Professional Modifier Low / Median / High Price $26.00 / $39.49 / $60.66	Professional		$26.00	$39.49	$60.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $13.36 / $22.44	Professional	26	$8.31	$13.36	$22.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.07 / $26.13 / $41.61	Professional	TC	$17.07	$26.13	$41.61