Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.54 / $158.76 / $490.65	Facility		$40.54	$158.76	$490.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.59 / $16.30 / $30.32	Facility	26	$9.59	$16.30	$30.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $32.86 / $60.52	Professional		$23.99	$32.86	$60.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $10.19 / $22.75	Professional	26	$9.11	$10.19	$22.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $23.63 / $44.19	Professional	TC	$19.76	$23.63	$44.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.93 / $141.16 / $184.67	Facility		$111.93	$141.16	$184.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $41.06 / $60.13	Professional		$31.65	$41.06	$60.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $11.91 / $17.95	Professional	26	$9.31	$11.91	$17.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.90 / $29.49 / $43.11	Professional	TC	$21.90	$29.49	$43.11
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.56 / $41.06 / $102.29	Professional		$35.56	$41.06	$102.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.60 / $11.91 / $15.13	Professional	26	$11.60	$11.91	$15.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $26.70 / $33.38	Professional	TC	$23.65	$26.70	$33.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.72 / $105.79 / $500.00	Facility		$53.72	$105.79	$500.00
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 Professional Modifier Low / Median / High Price $28.39 / $43.13 / $75.20	Professional		$28.39	$43.13	$75.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $13.90 / $23.97	Professional	26	$8.41	$13.90	$23.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.11 / $28.57 / $53.65	Professional	TC	$20.11	$28.57	$53.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $42.27 / $51.80	Professional		$35.22	$42.27	$51.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.94 / $14.39	Professional	26	$9.66	$11.94	$14.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.56 / $30.67 / $37.59	Professional	TC	$25.56	$30.67	$37.59
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.73 / $47.56 / $71.34	Facility		$30.73	$47.56	$71.34
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.93 / $18.00 / $33.13	Facility	26	$15.93	$18.00	$33.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $32.00 / $58.00	Professional		$14.21	$32.00	$58.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $13.71 / $32.36 / $66.41	Facility		$13.71	$32.36	$66.41
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.99 / $40.26 / $80.73	Professional		$14.99	$40.26	$80.73
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $15.27 / $24.18	Professional	26	$11.08	$15.27	$24.18
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $34.07 / $56.45	Professional	TC	$24.92	$34.07	$56.45
United Facility/Professional Facility Modifier Low / Median / High Price $99.68 / $185.87 / $185.87	Facility		$99.68	$185.87	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $42.92 / $65.69	Professional		$28.57	$42.92	$65.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $13.41 / $22.81	Professional	26	$8.27	$13.41	$22.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $28.71 / $43.99	Professional	TC	$19.19	$28.71	$43.99