Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $281.84 / $602.56	Facility		$47.86	$281.84	$602.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $12.02 / $32.36	Facility	26	$6.92	$12.02	$32.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $64.57 / $741.31	Facility	TC	$20.89	$64.57	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $28.18 / $69.18	Professional		$10.00	$28.18	$69.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.49 / $36.31	Professional	26	$7.08	$13.49	$36.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.98 / $58.88 / $190.55	Professional	50	$16.98	$58.88	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $47.86	Professional	TC	$16.98	$25.70	$47.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $120.23 / $151.36	Facility		$102.33	$120.23	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $37.15 / $57.54	Professional		$26.92	$37.15	$57.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.00 / $15.14	Professional	26	$7.24	$10.00	$15.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $57.54 / $87.10	Professional	50	$40.74	$57.54	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $27.54 / $42.66	Professional	TC	$19.50	$27.54	$42.66
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $95.50	Professional		$25.12	$33.11	$95.50
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.13 / $11.48	Professional	26	$7.41	$8.13	$11.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.39 / $38.02	Professional	TC	$20.42	$22.39	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $87.10 / $524.81	Facility		$48.98	$87.10	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.88	Facility	TC	$5.01	$23.44	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $34.67 / $61.66	Professional		$22.39	$34.67	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.55 / $17.38	Professional	26	$6.03	$9.55	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $44.67	Professional	TC	$16.60	$23.99	$44.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $42.66	Professional		$28.18	$33.88	$42.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.71 / $11.22	Professional	26	$7.08	$8.71	$11.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.70 / $32.36	Professional	TC	$20.89	$25.70	$32.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $44.67 / $63.10	Professional		$35.48	$44.67	$63.10
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.13 / $16.98	Professional	26	$11.48	$14.13	$16.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $37.15 / $58.88	Facility		$25.12	$37.15	$58.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $46.77	Professional		$30.20	$30.20	$46.77
Sentara Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $25.70 / $69.18	Facility		$8.91	$25.70	$69.18
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $31.62 / $123.03	Professional		$10.23	$31.62	$123.03
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $17.38	Professional	26	$7.94	$10.23	$17.38
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.92 / $46.77	Professional	TC	$20.42	$26.92	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $7.76 / $26.30 / $186.21	Facility		$7.76	$26.30	$186.21
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 $6.03 / $9.12 / $15.85	Professional	26	$6.03	$9.12	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.39 / $39.81	Professional	TC	$15.14	$22.39	$39.81