Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.35 / $228.16 / $598.29	Facility		$46.35	$228.16	$598.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.56 / $10.91 / $20.54	Facility	26	$6.56	$10.91	$20.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.73 / $404.50 / $875.04	Facility	TC	$20.73	$404.50	$875.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.10 / $27.22 / $49.45	Professional		$20.10	$27.22	$49.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $7.19 / $16.93	Professional	26	$6.35	$7.19	$16.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.70 / $85.70 / $85.70	Professional	50	$85.70	$85.70	$85.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.10 / $12.29 / $16.10	Professional	52	$10.10	$12.29	$16.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $20.28 / $36.25	Professional	TC	$16.82	$20.28	$36.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.42 / $108.99 / $142.59	Facility		$86.42	$108.99	$142.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.79 / $32.11 / $47.01	Professional		$24.79	$32.11	$47.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.48 / $12.69	Professional	26	$6.61	$8.48	$12.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.18 / $48.27 / $72.15	Professional	50	$37.18	$48.27	$72.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $23.89 / $34.92	Professional	TC	$17.48	$23.89	$34.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $30.55 / $82.57	Professional		$30.55	$30.55	$82.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $8.14 / $10.34	Professional	26	$8.10	$8.14	$10.34
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $22.41 / $28.46	Professional	TC	$20.17	$22.41	$28.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.81 / $84.14 / $500.00	Facility		$48.81	$84.14	$500.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $8.51	Facility	26	$8.51	$8.51	$8.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.67 / $34.65 / $59.39	Professional		$22.67	$34.65	$59.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.95 / $9.75 / $17.44	Professional	26	$5.95	$9.75	$17.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.79 / $24.68 / $42.89	Professional	TC	$16.79	$24.68	$42.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.25 / $32.70 / $40.08	Professional		$27.25	$32.70	$40.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.17 / $9.84	Professional	26	$6.61	$8.17	$9.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.64 / $24.77 / $30.35	Professional	TC	$20.64	$24.77	$30.35
Medcost Facility/Professional Facility Modifier Low / Median / High Price $24.56 / $37.42 / $57.73	Facility		$24.56	$37.42	$57.73
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $14.00 / $23.01	Facility	26	$11.13	$14.00	$23.01
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $23.48 / $38.25 / $58.07	Facility	TC	$23.48	$38.25	$58.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $27.00 / $48.00	Professional		$10.00	$27.00	$48.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $8.67 / $26.33 / $51.83	Facility		$8.67	$26.33	$51.83
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.65 / $32.56 / $62.59	Professional		$10.65	$32.56	$62.59
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.49 / $16.62	Professional	26	$7.79	$10.49	$16.62
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $20.55 / $28.59 / $46.00	Professional	TC	$20.55	$28.59	$46.00
United Facility/Professional Professional Modifier Low / Median / High Price $21.95 / $33.46 / $54.30	Professional		$21.95	$33.46	$54.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.96 / $9.25 / $14.78	Professional	26	$5.96	$9.25	$14.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.68 / $23.99 / $38.74	Professional	TC	$15.68	$23.99	$38.74