Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $50.12 / $489.78	Facility		$9.77	$50.12	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $13.49 / $60.26	Facility	26	$6.03	$13.49	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $15.49 / $35.48	Professional		$9.77	$15.49	$35.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.51 / $26.30	Professional	26	$6.03	$8.51	$26.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $11.48 / $11.48	Professional	50	$11.48	$11.48	$11.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.45 / $3.98 / $7.76	Professional	TC	$2.45	$3.98	$7.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $47.86 / $60.26	Facility		$40.74	$47.86	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $15.14 / $22.39	Professional		$11.22	$15.14	$22.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.47 / $15.14	Professional	26	$7.59	$10.47	$15.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $16.60 / $22.91 / $33.11	Professional	50	$16.60	$22.91	$33.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.47 / $4.79 / $7.24	Professional	TC	$3.47	$4.79	$7.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $12.59 / $39.81	Professional		$10.47	$12.59	$39.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.32 / $10.00	Professional	26	$7.41	$8.32	$10.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $3.80 / $4.27 / $5.13	Professional	TC	$3.80	$4.27	$5.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9.12 / $17.78 / $524.81	Facility		$9.12	$17.78	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.30	Facility	26	$1.86	$8.71	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $15.14 / $26.30	Professional		$9.55	$15.14	$26.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $10.47 / $17.38	Professional	26	$6.31	$10.47	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.69 / $4.79 / $8.71	Professional	TC	$2.69	$4.79	$8.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $13.18 / $16.60	Professional		$10.47	$13.18	$16.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.51 / $10.47	Professional	26	$6.76	$8.51	$10.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.80 / $4.68 / $5.75	Professional	TC	$3.80	$4.68	$5.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $19.95 / $21.38	Professional		$16.22	$19.95	$21.38
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.60 / $16.98	Professional	26	$13.18	$16.60	$16.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $16.22 / $25.70	Facility		$10.72	$16.22	$25.70
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.22 / $18.62	Professional		$11.22	$11.22	$18.62
Sentara Facility/Professional Facility Modifier Low / Median / High Price $4.57 / $11.22 / $21.88	Facility		$4.57	$11.22	$21.88
Sentara Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $14.13 / $26.30	Professional		$5.01	$14.13	$26.30
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.96 / $17.38	Professional	26	$8.32	$10.96	$17.38
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $3.47 / $5.62 / $8.32	Professional	TC	$3.47	$5.62	$8.32
United Facility/Professional Facility Modifier Low / Median / High Price $3.39 / $15.85 / $56.23	Facility		$3.39	$15.85	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $13.18 / $21.88	Professional		$9.12	$13.18	$21.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.71 / $14.79	Professional	26	$6.31	$8.71	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.14 / $3.89 / $7.41	Professional	TC	$2.14	$3.89	$7.41