Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $12.41 / $23.67	Facility	26	$7.50	$12.41	$23.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $34.22 / $63.12	Professional		$29.89	$34.22	$63.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $7.96 / $16.95	Professional	26	$7.01	$7.96	$16.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $26.91 / $49.21	Professional	TC	$22.57	$26.91	$49.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.31 / $42.18 / $61.66	Professional		$30.31	$42.18	$61.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $9.27 / $13.90	Professional	26	$7.21	$9.27	$13.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.60 / $33.17 / $48.57	Professional	TC	$23.60	$33.17	$48.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $41.74 / $88.31	Professional		$36.54	$41.74	$88.31
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 $27.64 / $30.47 / $38.09	Professional	TC	$27.64	$30.47	$38.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.63 / $40.46 / $77.79	Professional		$28.63	$40.46	$77.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $10.86 / $18.75	Professional	26	$6.55	$10.86	$18.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $29.79 / $60.82	Professional	TC	$21.27	$29.79	$60.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $43.67 / $53.51	Professional		$36.39	$43.67	$53.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.33 / $11.26	Professional	26	$7.56	$9.33	$11.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.83 / $34.60 / $42.40	Professional	TC	$28.83	$34.60	$42.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.15 / $15.00 / $25.84	Facility	26	$12.15	$15.00	$25.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.09 / $35.00 / $59.00	Professional		$11.09	$35.00	$59.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.63 / $39.22 / $75.00	Professional		$11.63	$39.22	$75.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $11.92 / $18.88	Professional	26	$8.55	$11.92	$18.88
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $27.06 / $38.63 / $63.93	Professional	TC	$27.06	$38.63	$63.93
United Facility/Professional Professional Modifier Low / Median / High Price $27.87 / $40.11 / $66.26	Professional		$27.87	$40.11	$66.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $10.58 / $16.37	Professional	26	$6.89	$10.58	$16.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.01 / $30.26 / $49.82	Professional	TC	$20.01	$30.26	$49.82