Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.45 / $18.60 / $36.17	Facility	26	$10.45	$18.60	$36.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $39.53 / $67.41	Professional		$33.47	$39.53	$67.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.83 / $11.47 / $23.04	Professional	26	$9.83	$11.47	$23.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $28.41 / $46.90	Professional	TC	$24.32	$28.41	$46.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $48.90 / $71.48	Professional		$36.06	$48.90	$71.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.63 / $13.45 / $20.19	Professional	26	$10.63	$13.45	$20.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $35.84 / $52.39	Professional	TC	$25.35	$35.84	$52.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $48.40 / $112.41	Professional		$42.97	$48.40	$112.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $12.98 / $16.48	Professional	26	$12.98	$12.98	$16.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.99 / $32.86 / $41.08	Professional	TC	$29.99	$32.86	$41.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $49.71 / $87.70	Professional		$33.75	$49.71	$87.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $15.59 / $26.48	Professional	26	$9.51	$15.59	$26.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.96 / $33.67 / $65.56	Professional	TC	$23.96	$33.67	$65.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.99 / $50.39 / $61.75	Professional		$41.99	$50.39	$61.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.86 / $13.42 / $15.98	Professional	26	$10.86	$13.42	$15.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.13 / $37.35 / $45.78	Professional	TC	$31.13	$37.35	$45.78
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.00 / $21.00 / $37.32	Facility	26	$18.00	$21.00	$37.32
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $38.00 / $70.00	Professional		$16.00	$38.00	$70.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $47.67 / $85.38	Professional		$16.82	$47.67	$85.38
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $16.87 / $26.47	Professional	26	$12.54	$16.87	$26.47
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $41.61 / $68.90	Professional	TC	$29.85	$41.61	$68.90
United Facility/Professional Professional Modifier Low / Median / High Price $32.89 / $50.49 / $77.34	Professional		$32.89	$50.49	$77.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $15.19 / $25.68	Professional	26	$9.69	$15.19	$25.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $32.79 / $54.26	Professional	TC	$23.08	$32.79	$54.26