Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.34 / $308.00 / $596.70	Facility		$51.34	$308.00	$596.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.89 / $11.71 / $22.60	Facility	26	$6.89	$11.71	$22.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.39 / $393.71 / $734.28	Facility	TC	$21.39	$393.71	$734.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $26.72 / $49.48	Professional		$18.55	$26.72	$49.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $7.64 / $18.62	Professional	26	$6.65	$7.64	$18.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.36 / $20.64 / $37.40	Professional	TC	$17.36	$20.64	$37.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.51 / $112.89 / $147.68	Facility		$89.51	$112.89	$147.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.62 / $32.86 / $49.49	Professional		$25.62	$32.86	$49.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $8.80 / $13.27	Professional	26	$6.91	$8.80	$13.27
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.43 / $49.39 / $76.14	Professional	50	$38.43	$49.39	$76.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.02 / $24.27 / $35.47	Professional	TC	$18.02	$24.27	$35.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $32.93 / $86.12	Professional		$30.55	$32.93	$86.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $8.94 / $11.37	Professional	26	$8.49	$8.94	$11.37
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $22.51 / $27.43	Professional	TC	$21.60	$22.51	$27.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.81 / $86.54 / $500.00	Facility		$48.81	$86.54	$500.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.41 / $35.90 / $61.69	Professional		$23.41	$35.90	$61.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.20 / $10.19 / $17.66	Professional	26	$6.20	$10.19	$17.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $25.07 / $44.01	Professional	TC	$16.64	$25.07	$44.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.24 / $33.88 / $41.53	Professional		$28.24	$33.88	$41.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $8.57 / $10.33	Professional	26	$6.94	$8.57	$10.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.29 / $25.55 / $31.31	Professional	TC	$21.29	$25.55	$31.31
Medcost Facility/Professional Facility Modifier Low / Median / High Price $25.44 / $38.57 / $58.80	Facility		$25.44	$38.57	$58.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $13.00 / $24.78	Facility	26	$11.13	$13.00	$24.78
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $24.23 / $40.61 / $56.26	Facility	TC	$24.23	$40.61	$56.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $29.00 / $49.00	Professional		$11.00	$29.00	$49.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $9.06 / $27.03 / $53.77	Facility		$9.06	$27.03	$53.77
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $33.29 / $64.11	Professional		$11.00	$33.29	$64.11
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $10.97 / $17.38	Professional	26	$8.06	$10.97	$17.38
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $28.71 / $46.76	Professional	TC	$21.33	$28.71	$46.76
United Facility/Professional Facility Modifier Low / Median / High Price $35.76 / $185.87 / $185.87	Facility		$35.76	$185.87	$185.87
United Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $34.75 / $58.39	Professional		$23.17	$34.75	$58.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.56 / $10.32 / $15.86	Professional	26	$6.56	$10.32	$15.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.07 / $24.43 / $37.88	Professional	TC	$16.07	$24.43	$37.88