Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.64 / $13.37 / $24.68	Facility	26	$7.64	$13.37	$24.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $29.05 / $45.75	Professional		$21.73	$29.05	$45.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.29 / $7.79 / $15.36	Professional	26	$7.29	$7.79	$15.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.94 / $36.94 / $36.94	Professional	50	$36.94	$36.94	$36.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $21.54 / $31.73	Professional	TC	$18.35	$21.54	$31.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $36.58 / $53.47	Professional		$25.84	$36.58	$53.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.42 / $14.00	Professional	26	$7.41	$9.42	$14.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.76 / $54.89 / $80.34	Professional	50	$38.76	$54.89	$80.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.21 / $27.21 / $39.83	Professional	TC	$17.21	$27.21	$39.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $35.83 / $76.56	Professional		$31.64	$35.83	$76.56
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $8.90 / $11.30	Professional	26	$8.90	$8.90	$11.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $24.31 / $30.39	Professional	TC	$22.74	$24.31	$30.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $34.96 / $66.29	Professional		$24.58	$34.96	$66.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.88 / $19.03	Professional	26	$6.77	$10.88	$19.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.37 / $24.76 / $48.83	Professional	TC	$17.37	$24.76	$48.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $38.11 / $46.71	Professional		$31.76	$38.11	$46.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $9.69 / $11.69	Professional	26	$7.85	$9.69	$11.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.92 / $28.70 / $35.18	Professional	TC	$23.92	$28.70	$35.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.15 / $15.00 / $24.84	Facility	26	$12.15	$15.00	$24.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $29.00 / $50.00	Professional		$11.00	$29.00	$50.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $34.34 / $63.44	Professional		$11.53	$34.34	$63.44
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $12.29 / $19.52	Professional	26	$8.73	$12.29	$19.52
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $30.94 / $51.28	Professional	TC	$22.22	$30.94	$51.28
United Facility/Professional Professional Modifier Low / Median / High Price $22.40 / $34.58 / $56.45	Professional		$22.40	$34.58	$56.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.68 / $10.33 / $17.30	Professional	26	$6.68	$10.33	$17.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.27 / $23.30 / $40.83	Professional	TC	$16.27	$23.30	$40.83