Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $239.88 / $660.69	Facility		$44.67	$239.88	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $12.88 / $33.88	Facility	26	$7.08	$12.88	$33.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $40.74 / $354.81	Facility	TC	$20.89	$40.74	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $36.31 / $83.18	Professional		$21.38	$36.31	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.72 / $28.84	Professional	26	$7.08	$10.72	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $47.86	Professional	TC	$15.14	$22.91	$47.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $117.49 / $147.91	Facility		$97.72	$117.49	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $58.88	Professional		$26.30	$36.31	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.72 / $16.60	Professional	26	$7.76	$10.72	$16.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $41.69	Professional	TC	$18.20	$25.12	$41.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $31.62 / $97.72	Professional		$14.13	$31.62	$97.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.91 / $11.22	Professional	26	$7.94	$8.91	$11.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.91 / $32.36	Professional	TC	$20.42	$22.91	$32.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $95.50 / $524.81	Facility		$43.65	$95.50	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.57 / $21.38 / $30.20	Facility	TC	$4.57	$21.38	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $34.67 / $60.26	Professional		$22.39	$34.67	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.47 / $18.20	Professional	26	$6.61	$10.47	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $23.99 / $43.65	Professional	TC	$15.49	$23.99	$43.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.11 / $40.74	Professional		$27.54	$33.11	$40.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.55 / $12.02	Professional	26	$7.76	$9.55	$12.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.44 / $28.84	Professional	TC	$19.50	$23.44	$28.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $60.26	Professional		$36.31	$45.71	$60.26
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.49 / $18.20	Professional	26	$12.30	$15.49	$18.20
Medcost Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $38.02 / $58.88	Facility		$24.55	$38.02	$58.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $44.67	Professional		$34.67	$34.67	$44.67
Sentara Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $26.30 / $66.07	Facility		$10.00	$26.30	$66.07
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $31.62 / $141.25	Professional		$10.96	$31.62	$141.25
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $19.05	Professional	26	$8.51	$11.22	$19.05
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.55 / $42.66	Professional	TC	$19.05	$24.55	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $26.30 / $251.19	Facility		$8.51	$26.30	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $54.95	Professional		$21.38	$32.36	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.77 / $17.38	Professional	26	$6.46	$9.77	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $38.90	Professional	TC	$15.14	$21.88	$38.90