Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.20 / $166.71 / $934.83	Facility		$36.20	$166.71	$934.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.56 / $22.35 / $100.44	Facility	26	$12.56	$22.35	$100.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.44 / $36.79 / $63.86	Professional		$30.44	$36.79	$63.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $13.85 / $27.69	Professional	26	$12.24	$13.85	$27.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $22.48 / $40.68	Professional	TC	$17.39	$22.48	$40.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.49 / $146.91 / $192.20	Facility		$116.49	$146.91	$192.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $43.02 / $61.99	Professional		$33.65	$43.02	$61.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $15.62 / $22.09	Professional	26	$12.32	$15.62	$22.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $27.68 / $39.88	Professional	TC	$20.71	$27.68	$39.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $42.30 / $100.38	Professional		$42.30	$42.30	$100.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.94 / $15.94 / $30.13	Professional	26	$15.94	$15.94	$30.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $26.35 / $49.80	Professional	TC	$23.72	$26.35	$49.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $42.87	Facility		$42.87	$42.87	$42.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $42.18 / $88.86	Professional		$29.48	$42.18	$88.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.73 / $18.05 / $32.50	Professional	26	$10.73	$18.05	$32.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $23.85 / $53.44	Professional	TC	$17.39	$23.85	$53.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $43.87 / $54.11	Professional		$36.56	$43.87	$54.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.76 / $14.81 / $18.88	Professional	26	$12.76	$14.81	$18.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.80 / $28.91 / $35.22	Professional	TC	$23.80	$28.91	$35.22
Medcost Facility/Professional Facility Modifier Low / Median / High Price $31.59 / $47.35 / $63.49	Facility		$31.59	$47.35	$63.49
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.71 / $26.00 / $53.14	Facility	26	$21.71	$26.00	$53.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $32.00 / $58.00	Professional		$19.00	$32.00	$58.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $30.69 / $59.84	Facility		$16.89	$30.69	$59.84
Sentara Facility/Professional Professional Modifier Low / Median / High Price $18.32 / $40.97 / $75.50	Professional		$18.32	$40.97	$75.50
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $19.51 / $31.65	Professional	26	$14.75	$19.51	$31.65
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $30.02 / $51.52	Professional	TC	$21.48	$30.02	$51.52
United Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $39.86 / $62.03	Professional		$27.45	$39.86	$62.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $17.23 / $25.16	Professional	26	$11.03	$17.23	$25.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.98 / $23.66 / $38.89	Professional	TC	$15.98	$23.66	$38.89