Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11.40 / $56.72 / $116.89	Facility		$11.40	$56.72	$116.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.97 / $12.50 / $30.10	Facility	26	$6.97	$12.50	$30.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.02 / $11.81 / $25.08	Professional		$10.02	$11.81	$25.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $7.48 / $16.30	Professional	26	$6.93	$7.48	$16.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.19 / $4.09 / $7.84	Professional	TC	$3.19	$4.09	$7.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.97 / $42.84 / $56.05	Facility		$33.97	$42.84	$56.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.32 / $13.31 / $18.32	Professional		$10.32	$13.31	$18.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $9.03 / $12.46	Professional	26	$6.91	$9.03	$12.46
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $15.33 / $19.69 / $27.48	Professional	50	$15.33	$19.69	$27.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.30 / $4.25 / $5.92	Professional	TC	$3.30	$4.25	$5.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $13.76 / $13.79 / $38.35	Professional		$13.76	$13.79	$38.35
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $8.52 / $16.10	Professional	26	$8.52	$8.52	$16.10
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $5.23 / $5.26 / $9.94	Professional	TC	$5.23	$5.26	$9.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9.34 / $14.54 / $85.84	Facility		$9.34	$14.54	$85.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.76 / $8.76 / $8.76	Facility	26	$8.76	$8.76	$8.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.35 / $15.49 / $26.85	Professional		$9.35	$15.49	$26.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $10.54 / $18.22	Professional	26	$6.21	$10.54	$18.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.70 / $4.90 / $8.98	Professional	TC	$2.70	$4.90	$8.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.61 / $13.10 / $15.92	Professional		$10.61	$13.10	$15.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $8.80 / $10.85	Professional	26	$7.01	$8.80	$10.85
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.43 / $4.38 / $5.44	Professional	TC	$3.43	$4.38	$5.44
Medcost Facility/Professional Facility Modifier Low / Median / High Price $10.66 / $17.48 / $23.82	Facility		$10.66	$17.48	$23.82
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.58 / $14.82 / $26.10	Facility	26	$12.58	$14.82	$26.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $6.00 / $13.49 / $22.00	Professional		$6.00	$13.49	$22.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $4.78 / $11.38 / $21.59	Facility		$4.78	$11.38	$21.59
Sentara Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $15.04 / $25.58	Professional		$5.01	$15.04	$25.58
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $11.76 / $18.19	Professional	26	$9.06	$11.76	$18.19
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $3.79 / $5.91 / $8.63	Professional	TC	$3.79	$5.91	$8.63
United Facility/Professional Facility Modifier Low / Median / High Price $43.13 / $47.80 / $114.23	Facility		$43.13	$47.80	$114.23
United Facility/Professional Professional Modifier Low / Median / High Price $9.11 / $14.36 / $22.03	Professional		$9.11	$14.36	$22.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.18 / $9.48 / $14.70	Professional	26	$6.18	$9.48	$14.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.42 / $3.89 / $7.40	Professional	TC	$2.42	$3.89	$7.40