Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.49 / $301.32 / $771.53	Facility		$61.49	$301.32	$771.53
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.18 / $11.91 / $22.78	Facility	26	$7.18	$11.91	$22.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.38 / $418.47 / $875.04	Facility	TC	$30.38	$418.47	$875.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.27 / $31.94 / $60.94	Professional		$13.27	$31.94	$60.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $8.75 / $24.87	Professional	26	$6.93	$8.75	$24.87
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.64 / $28.49 / $91.36	Professional	50	$15.64	$28.49	$91.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.55 / $15.04 / $17.44	Professional	52	$11.55	$15.04	$17.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $26.00 / $46.28	Professional	TC	$20.21	$26.00	$46.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $103.91 / $131.05 / $171.44	Facility		$103.91	$131.05	$171.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.12 / $38.45 / $56.21	Professional		$28.12	$38.45	$56.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $9.26 / $13.79	Professional	26	$7.21	$9.26	$13.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.18 / $57.68 / $84.46	Professional	50	$42.18	$57.68	$84.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $29.49 / $43.11	Professional	TC	$22.11	$29.49	$43.11
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $38.04 / $89.49	Professional		$35.04	$38.04	$89.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $8.90 / $11.30	Professional	26	$8.86	$8.90	$11.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $27.05 / $33.81	Professional	TC	$26.13	$27.05	$33.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.82 / $93.55 / $500.00	Facility		$57.82	$93.55	$500.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.41 / $39.14 / $70.45	Professional		$26.41	$39.14	$70.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $10.65 / $18.25	Professional	26	$6.49	$10.65	$18.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $28.16 / $53.70	Professional	TC	$19.91	$28.16	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.78 / $39.34 / $48.21	Professional		$32.78	$39.34	$48.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $8.93 / $10.76	Professional	26	$7.23	$8.93	$10.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.56 / $30.67 / $37.59	Professional	TC	$25.56	$30.67	$37.59
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.62 / $44.52 / $63.00	Facility		$28.62	$44.52	$63.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.15 / $17.00 / $28.46	Facility	26	$12.15	$17.00	$28.46
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $29.42 / $45.12 / $67.14	Facility	TC	$29.42	$45.12	$67.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $33.00 / $57.00	Professional		$11.00	$33.00	$57.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $9.44 / $31.70 / $61.06	Facility		$9.44	$31.70	$61.06
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.62 / $37.40 / $75.44	Professional		$11.62	$37.40	$75.44
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.50 / $11.44 / $18.12	Professional	26	$8.50	$11.44	$18.12
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.51 / $56.45	Professional	TC	$25.12	$34.51	$56.45
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 $25.52 / $39.47 / $59.76	Professional		$25.52	$39.47	$59.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $10.11 / $16.07	Professional	26	$6.50	$10.11	$16.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $27.65 / $46.33	Professional	TC	$18.48	$27.65	$46.33