Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.47 / $226.14 / $695.20	Facility		$39.47	$226.14	$695.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.22 / $11.91 / $20.54	Facility	26	$7.22	$11.91	$20.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.35 / $337.85 / $722.88	Facility	TC	$24.35	$337.85	$722.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $29.09 / $53.93	Professional		$21.26	$29.09	$53.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $7.72 / $16.82	Professional	26	$6.95	$7.72	$16.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $348.00 / $348.00 / $348.00	Professional	50	$348.00	$348.00	$348.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.64 / $14.02 / $22.07	Professional	52	$11.64	$14.02	$22.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $22.68 / $41.41	Professional	TC	$18.53	$22.68	$41.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.77 / $123.30 / $161.31	Facility		$97.77	$123.30	$161.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.25 / $36.21 / $53.02	Professional		$27.25	$36.21	$53.02
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 $40.86 / $54.44 / $83.63	Professional	50	$40.86	$54.44	$83.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.11 / $27.62 / $40.38	Professional	TC	$20.11	$27.62	$40.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.06 / $36.25 / $82.57	Professional		$32.06	$36.25	$82.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $8.94 / $11.37	Professional	26	$8.10	$8.94	$11.37
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.11 / $24.99 / $31.24	Professional	TC	$23.11	$24.99	$31.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.27 / $89.43 / $500.00	Facility		$51.27	$89.43	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $36.34 / $66.03	Professional		$24.76	$36.34	$66.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.20 / $10.29 / $18.03	Professional	26	$6.20	$10.29	$18.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.44 / $25.90 / $50.20	Professional	TC	$18.44	$25.90	$50.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $37.03 / $45.38	Professional		$30.86	$37.03	$45.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $8.57 / $10.61	Professional	26	$6.94	$8.57	$10.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.92 / $28.70 / $35.18	Professional	TC	$23.92	$28.70	$35.18
Medcost Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $41.77 / $57.79	Facility		$27.54	$41.77	$57.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $16.52 / $24.78	Facility	26	$11.13	$16.52	$24.78
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $25.38 / $29.92 / $64.16	Facility	TC	$25.38	$29.92	$64.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $30.00 / $51.00	Professional		$11.00	$30.00	$51.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $9.44 / $29.24 / $58.11	Facility		$9.44	$29.24	$58.11
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $34.01 / $71.66	Professional		$11.00	$34.01	$71.66
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.33 / $11.30 / $18.12	Professional	26	$8.33	$11.30	$18.12
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $23.21 / $31.89 / $53.54	Professional	TC	$23.21	$31.89	$53.54
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 $24.40 / $37.09 / $58.68	Professional		$24.40	$37.09	$58.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $10.18 / $15.86	Professional	26	$6.52	$10.18	$15.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.93 / $25.56 / $44.88	Professional	TC	$15.93	$25.56	$44.88