Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $309.03 / $741.31	Facility		$63.10	$309.03	$741.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $13.80 / $36.31	Facility	26	$7.94	$13.80	$36.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $223.87 / $741.31	Facility	TC	$25.12	$223.87	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $33.11 / $93.33	Professional		$9.12	$33.11	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.80 / $44.67	Professional	26	$7.94	$13.80	$44.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $67.61 / $165.96	Professional	50	$30.20	$67.61	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.11 / $79.43	Professional	TC	$19.05	$33.11	$79.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $147.91 / $186.21	Facility		$125.89	$147.91	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $69.18	Professional		$31.62	$44.67	$69.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $17.78	Professional	26	$8.51	$11.48	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $67.61 / $107.15	Professional	50	$47.86	$67.61	$107.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $51.29	Professional	TC	$22.39	$33.11	$51.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $38.90 / $112.20	Professional		$14.79	$38.90	$112.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.55 / $12.02	Professional	26	$8.71	$9.55	$12.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $29.51 / $44.67	Professional	TC	$25.12	$29.51	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $114.82 / $524.81	Facility		$53.70	$114.82	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	TC	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $70.79	Professional		$25.70	$38.90	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $19.95	Professional	26	$7.08	$11.22	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $52.48	Professional	TC	$18.62	$26.92	$52.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $51.29	Professional		$34.67	$41.69	$51.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.23 / $13.18	Professional	26	$8.32	$10.23	$13.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $32.36 / $38.90	Professional	TC	$26.30	$32.36	$38.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $74.13	Professional		$40.74	$51.29	$74.13
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $19.05	Professional	26	$12.88	$16.22	$19.05
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $43.65 / $70.79	Facility		$28.18	$43.65	$70.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $56.23	Professional		$30.20	$30.20	$56.23
Sentara Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $29.51 / $79.43	Facility		$10.96	$29.51	$79.43
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $35.48 / $154.88	Professional		$11.75	$35.48	$154.88
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $20.42	Professional	26	$9.12	$12.02	$20.42
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $54.95	Professional	TC	$22.91	$29.51	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $29.51 / $186.21	Facility		$8.91	$29.51	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $37.15 / $61.66	Professional		$23.99	$37.15	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $18.20	Professional	26	$6.92	$10.47	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $44.67	Professional	TC	$16.98	$25.70	$44.67