Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.74 / $14.95 / $33.39	Facility	26	$8.74	$14.95	$33.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.19 / $29.51 / $52.90	Professional		$23.19	$29.51	$52.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $9.23 / $17.47	Professional	26	$7.98	$9.23	$17.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.29 / $20.35 / $38.04	Professional	TC	$15.29	$20.35	$38.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $35.84 / $55.18	Professional		$28.86	$35.84	$55.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $10.70 / $16.14	Professional	26	$8.60	$10.70	$16.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.16 / $25.38 / $37.22	Professional	TC	$19.16	$25.38	$37.22
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $35.92 / $103.93	Professional		$33.04	$35.92	$103.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $10.84 / $13.77	Professional	26	$10.03	$10.84	$13.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.21 / $25.08 / $28.68	Professional	TC	$22.21	$25.08	$28.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.79 / $10.79 / $10.79	Facility	26	$10.79	$10.79	$10.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.57 / $40.07 / $67.03	Professional		$25.57	$40.07	$67.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.60 / $12.41 / $21.75	Professional	26	$7.60	$12.41	$21.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $26.99 / $46.85	Professional	TC	$17.67	$26.99	$46.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $36.89 / $45.21	Professional		$30.74	$36.89	$45.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.78 / $10.86 / $13.10	Professional	26	$8.78	$10.86	$13.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.96 / $26.35 / $32.29	Professional	TC	$21.96	$26.35	$32.29
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.22 / $16.00 / $29.94	Facility	26	$13.22	$16.00	$29.94
Medcost Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $30.00 / $53.28	Professional		$13.00	$30.00	$53.28
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $36.53 / $62.64	Professional		$13.05	$36.53	$62.64
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $13.84 / $21.92	Professional	26	$9.74	$13.84	$21.92
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $22.54 / $30.24 / $48.96	Professional	TC	$22.54	$30.24	$48.96
United Facility/Professional Professional Modifier Low / Median / High Price $24.91 / $37.76 / $60.39	Professional		$24.91	$37.76	$60.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.81 / $18.85	Professional	26	$7.76	$11.81	$18.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.86 / $25.28 / $44.46	Professional	TC	$16.86	$25.28	$44.46