Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.07 / $18.89 / $37.19	Facility	26	$11.07	$18.89	$37.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $42.80 / $75.30	Professional		$36.32	$42.80	$75.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $12.10 / $22.00	Professional	26	$10.02	$12.10	$22.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.85 / $31.09 / $54.67	Professional	TC	$26.85	$31.09	$54.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.99 / $53.01 / $77.63	Professional		$39.99	$53.01	$77.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $14.15 / $21.34	Professional	26	$11.24	$14.15	$21.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.85 / $39.20 / $57.30	Professional	TC	$27.85	$39.20	$57.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $52.48 / $133.15	Professional		$46.32	$52.48	$133.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.75 / $13.75 / $17.46	Professional	26	$13.75	$13.75	$17.46
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.57 / $35.94 / $44.92	Professional	TC	$32.57	$35.94	$44.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $55.16 / $96.26	Professional		$36.65	$55.16	$96.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $16.47 / $27.99	Professional	26	$10.05	$16.47	$27.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.97 / $38.78 / $71.89	Professional	TC	$26.97	$38.78	$71.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.91 / $53.89 / $66.04	Professional		$44.91	$53.89	$66.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $13.78 / $16.61	Professional	26	$11.15	$13.78	$16.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.75 / $40.50 / $49.64	Professional	TC	$33.75	$40.50	$49.64
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.38 / $22.00 / $39.38	Facility	26	$18.38	$22.00	$39.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $42.00 / $75.00	Professional		$17.00	$42.00	$75.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $51.88 / $92.65	Professional		$17.64	$51.88	$92.65
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $17.80 / $27.97	Professional	26	$12.92	$17.80	$27.97
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $33.76 / $45.89 / $75.55	Professional	TC	$33.76	$45.89	$75.55
United Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $55.39 / $84.74	Professional		$36.47	$55.39	$84.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.13 / $16.13 / $27.38	Professional	26	$10.13	$16.13	$27.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.45 / $36.14 / $61.09	Professional	TC	$25.45	$36.14	$61.09