Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $229.09 / $758.58	Facility		$63.10	$229.09	$758.58
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 $30.90 / $154.88 / $741.31	Facility	TC	$30.90	$154.88	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $38.90 / $123.03	Professional		$9.12	$38.90	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.85 / $48.98	Professional	26	$8.32	$15.85	$48.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.95 / $75.86 / $204.17	Professional	50	$19.95	$75.86	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $40.74 / $95.50	Professional	TC	$24.55	$40.74	$95.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $177.83 / $223.87	Facility		$151.36	$177.83	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $85.11	Professional		$36.31	$52.48	$85.11
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 $54.95 / $79.43 / $128.82	Professional	50	$54.95	$79.43	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $39.81 / $63.10	Professional	TC	$26.92	$39.81	$63.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $45.71 / $97.72	Professional		$9.55	$45.71	$97.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.33 / $13.80	Professional	26	$8.71	$9.33	$13.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $36.31 / $54.95	Professional	TC	$33.11	$36.31	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $125.89 / $524.81	Facility		$67.61	$125.89	$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 $7.41 / $34.67 / $48.98	Facility	TC	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $43.65 / $83.18	Professional		$30.20	$43.65	$83.18
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 $22.91 / $31.62 / $66.07	Professional	TC	$22.91	$31.62	$66.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $61.66	Professional		$41.69	$50.12	$61.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.72 / $13.49	Professional	26	$8.71	$10.72	$13.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $39.81 / $48.98	Professional	TC	$32.36	$39.81	$48.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $87.10	Professional		$40.74	$51.29	$87.10
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $19.50	Professional	26	$12.88	$16.22	$19.50
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $50.12 / $79.43	Facility		$33.11	$50.12	$79.43
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $66.07	Professional		$34.67	$34.67	$66.07
Sentara Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $35.48 / $95.50	Facility		$10.96	$35.48	$95.50
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $40.74 / $144.54	Professional		$11.75	$40.74	$144.54
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 $25.70 / $37.15 / $69.18	Professional	TC	$25.70	$37.15	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $30.90 / $186.21	Facility		$9.33	$30.90	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $41.69 / $74.13	Professional		$26.30	$41.69	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $18.62	Professional	26	$6.92	$10.47	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $56.23	Professional	TC	$19.95	$30.90	$56.23