Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $199.53 / $588.84	Facility		$51.29	$199.53	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $16.22 / $42.66	Facility	26	$9.55	$16.22	$42.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $85.11 / $512.86	Facility	TC	$27.54	$85.11	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $109.65	Professional		$31.62	$50.12	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $16.98 / $37.15	Professional	26	$9.12	$16.98	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $35.48 / $72.44	Professional	TC	$21.88	$35.48	$72.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $165.96 / $208.93	Facility		$141.25	$165.96	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $83.18	Professional		$36.31	$51.29	$83.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.80 / $20.89	Professional	26	$10.00	$13.80	$20.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $37.15 / $57.54	Professional	TC	$26.30	$37.15	$57.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $44.67 / $117.49	Professional		$21.38	$44.67	$117.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $11.48 / $17.38	Professional	26	$10.23	$11.48	$17.38
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $30.20 / $47.86	Professional	TC	$28.18	$30.20	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $117.49 / $524.81	Facility		$69.18	$117.49	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	TC	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $81.28	Professional		$30.20	$45.71	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.49 / $23.44	Professional	26	$8.51	$13.49	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $60.26	Professional	TC	$21.38	$30.20	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $46.77 / $57.54	Professional		$38.90	$46.77	$57.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $11.75 / $15.14	Professional	26	$9.55	$11.75	$15.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $35.48 / $43.65	Professional	TC	$28.84	$35.48	$43.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $85.11	Professional		$44.67	$54.95	$85.11
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.05 / $23.44	Professional	26	$15.49	$19.05	$23.44
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $50.12 / $77.62	Facility		$33.11	$50.12	$77.62
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $64.57	Professional		$39.81	$39.81	$64.57
Sentara Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $33.88 / $89.13	Facility		$12.88	$33.88	$89.13
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $41.69 / $151.36	Professional		$13.80	$41.69	$151.36
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.45 / $23.99	Professional	26	$10.96	$14.45	$23.99
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $35.48 / $61.66	Professional	TC	$22.39	$35.48	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $30.90 / $186.21	Facility		$10.72	$30.90	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $75.86	Professional		$27.54	$41.69	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.59 / $21.88	Professional	26	$8.32	$12.59	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $52.48	Professional	TC	$19.95	$28.84	$52.48