Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $194.98 / $537.03	Facility		$66.07	$194.98	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $15.49 / $52.48	Facility	26	$8.91	$15.49	$52.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $169.82 / $512.86	Facility	TC	$22.91	$169.82	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $97.72	Professional		$26.92	$41.69	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.49 / $40.74	Professional	26	$8.91	$13.49	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.18 / $63.10	Professional	TC	$18.20	$28.18	$63.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $138.04 / $173.78	Facility		$117.49	$138.04	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $43.65 / $66.07	Professional		$30.90	$43.65	$66.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.80 / $20.42	Professional	26	$9.77	$13.80	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $45.71	Professional	TC	$21.38	$30.20	$45.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $35.48 / $245.47	Professional		$9.77	$35.48	$245.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.48 / $16.98	Professional	26	$10.96	$11.48	$16.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $28.84 / $40.74	Professional	TC	$24.55	$28.84	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $93.33 / $524.81	Facility		$52.48	$93.33	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.37 / $25.12 / $36.31	Facility	TC	$5.37	$25.12	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $69.18	Professional		$25.70	$38.90	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $22.91	Professional	26	$7.94	$12.88	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $24.55 / $47.86	Professional	TC	$16.98	$24.55	$47.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.90 / $47.86	Professional		$32.36	$38.90	$47.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.48 / $13.80	Professional	26	$9.33	$11.48	$13.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $27.54 / $33.88	Professional	TC	$22.39	$27.54	$33.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $22.39	Professional	26	$22.39	$22.39	$22.39
Medcost Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $39.81 / $61.66	Facility		$27.54	$39.81	$61.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $54.95	Professional		$26.92	$26.92	$54.95
Sentara Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $27.54 / $67.61	Facility		$12.59	$27.54	$67.61
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $34.67 / $109.65	Professional		$13.49	$34.67	$109.65
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.80 / $23.44	Professional	26	$10.72	$13.80	$23.44
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $50.12	Professional	TC	$19.50	$26.92	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $27.54 / $186.21	Facility		$10.96	$27.54	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $61.66	Professional		$23.99	$36.31	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.30 / $21.88	Professional	26	$8.13	$12.30	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $41.69	Professional	TC	$15.85	$23.99	$41.69