Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.27 / $13.86 / $30.04	Facility	26	$8.27	$13.86	$30.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $34.42 / $54.93	Professional		$25.85	$34.42	$54.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $8.27 / $14.50	Professional	26	$6.90	$8.27	$14.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $26.01 / $41.17	Professional	TC	$19.72	$26.01	$41.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $43.68 / $63.84	Professional		$30.86	$43.68	$63.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $9.94 / $15.00	Professional	26	$7.90	$9.94	$15.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.74 / $33.90 / $49.65	Professional	TC	$21.74	$33.90	$49.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $43.24 / $89.33	Professional		$39.14	$43.24	$89.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $9.67 / $12.28	Professional	26	$9.66	$9.67	$12.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.48 / $30.47 / $38.09	Professional	TC	$29.48	$30.47	$38.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.77 / $40.36 / $76.58	Professional		$28.77	$40.36	$76.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $11.40 / $19.46	Professional	26	$7.02	$11.40	$19.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.43 / $29.91 / $60.82	Professional	TC	$21.43	$29.91	$60.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $44.80 / $54.90	Professional		$37.33	$44.80	$54.90
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 $29.49 / $35.38 / $43.36	Professional	TC	$29.49	$35.38	$43.36
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.81 / $15.00 / $26.90	Facility	26	$12.81	$15.00	$26.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $33.00 / $59.00	Professional		$12.00	$33.00	$59.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.43 / $39.93 / $75.53	Professional		$12.43	$39.93	$75.53
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $12.40 / $19.64	Professional	26	$8.94	$12.40	$19.64
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $26.31 / $38.47 / $63.93	Professional	TC	$26.31	$38.47	$63.93
United Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $40.89 / $66.83	Professional		$27.77	$40.89	$66.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.98 / $16.89	Professional	26	$7.25	$10.98	$16.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.02 / $29.27 / $49.80	Professional	TC	$20.02	$29.27	$49.80