Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $275.42 / $660.69	Facility		$57.54	$275.42	$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 $22.91 / $91.20 / $776.25	Facility	TC	$22.91	$91.20	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $31.62 / $85.11	Professional		$8.91	$31.62	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $13.80 / $38.90	Professional	26	$7.24	$13.80	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $93.33 / $177.83	Professional	50	$30.20	$93.33	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.11 / $64.57	Professional	TC	$19.05	$33.11	$64.57
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 $30.20 / $42.66 / $66.07	Professional		$30.20	$42.66	$66.07
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 50 Low / Median / High Price $45.71 / $64.57 / $102.33	Professional	50	$45.71	$64.57	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $48.98	Professional	TC	$22.39	$30.90	$48.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $33.88 / $95.50	Professional		$8.91	$33.88	$95.50
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.32 / $12.59	Professional	26	$7.94	$8.32	$12.59
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $28.18 / $42.66	Professional	TC	$23.99	$28.18	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $97.72 / $524.81	Facility		$58.88	$97.72	$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 $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $39.81 / $67.61	Professional		$25.12	$39.81	$67.61
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 $19.05 / $29.51 / $51.29	Professional	TC	$19.05	$29.51	$51.29
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 $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 $23.99 / $29.51 / $36.31	Professional	TC	$23.99	$29.51	$36.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $70.79	Professional		$39.81	$50.12	$70.79
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 $28.18 / $43.65 / $67.61	Facility		$28.18	$43.65	$67.61
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $52.48	Professional		$30.20	$30.20	$52.48
Sentara Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $30.20 / $79.43	Facility		$9.77	$30.20	$79.43
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $37.15 / $144.54	Professional		$10.72	$37.15	$144.54
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $19.05	Professional	26	$8.32	$11.22	$19.05
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $31.62 / $51.29	Professional	TC	$23.44	$31.62	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $29.51 / $186.21	Facility		$8.51	$29.51	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $63.10	Professional		$23.99	$36.31	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.77 / $16.98	Professional	26	$6.46	$9.77	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.30 / $44.67	Professional	TC	$17.38	$26.30	$44.67