Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $235.42 / $517.91	Facility		$60.00	$235.42	$517.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.79 / $10.90 / $24.64	Facility	26	$7.79	$10.90	$24.64
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.66 / $270.00 / $523.50	Facility	TC	$26.66	$270.00	$523.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.80 / $31.24 / $60.09	Professional		$12.80	$31.24	$60.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $8.49 / $18.37	Professional	26	$7.51	$8.49	$18.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $24.23 / $45.32	Professional	TC	$20.96	$24.23	$45.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.02 / $137.49 / $179.88	Facility		$109.02	$137.49	$179.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $40.93 / $60.86	Professional		$30.51	$40.93	$60.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $10.03 / $15.33	Professional	26	$7.81	$10.03	$15.33
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.76 / $60.05 / $92.25	Professional	50	$45.76	$60.05	$92.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $30.98 / $46.07	Professional	TC	$22.74	$30.98	$46.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $40.33 / $95.99	Professional		$35.67	$40.33	$95.99
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $10.69 / $13.58	Professional	26	$10.45	$10.69	$13.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $27.05 / $33.81	Professional	TC	$24.98	$27.05	$33.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.02 / $108.47 / $500.00	Facility		$64.02	$108.47	$500.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.51 / $42.25 / $73.56	Professional		$27.51	$42.25	$73.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $11.69 / $19.46	Professional	26	$7.02	$11.69	$19.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $29.64 / $54.34	Professional	TC	$20.38	$29.64	$54.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.38 / $41.26 / $50.56	Professional		$34.38	$41.26	$50.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $9.69 / $11.63	Professional	26	$7.85	$9.69	$11.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.54 / $31.84 / $39.03	Professional	TC	$26.54	$31.84	$39.03
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.76 / $45.21 / $60.09	Facility		$29.76	$45.21	$60.09
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.83 / $24.09 / $32.59	Facility	26	$15.83	$24.09	$32.59
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $31.88 / $70.12	Facility	TC	$30.20	$31.88	$70.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $33.00 / $63.00	Professional		$12.00	$33.00	$63.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $11.29 / $32.03 / $62.49	Facility		$11.29	$32.03	$62.49
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.52 / $38.76 / $76.20	Professional		$12.52	$38.76	$76.20
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.56 / $12.52 / $19.64	Professional	26	$9.56	$12.52	$19.64
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $25.17 / $34.51 / $55.43	Professional	TC	$25.17	$34.51	$55.43
United Facility/Professional Professional Modifier Low / Median / High Price $27.41 / $41.63 / $64.03	Professional		$27.41	$41.63	$64.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $11.04 / $18.11	Professional	26	$7.26	$11.04	$18.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.02 / $30.08 / $47.81	Professional	TC	$19.02	$30.08	$47.81