Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.97 / $21.30 / $40.33	Facility	26	$11.97	$21.30	$40.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $44.39 / $78.54	Professional		$37.07	$44.39	$78.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.52 / $12.75 / $23.91	Professional	26	$10.52	$12.75	$23.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.53 / $31.57 / $58.19	Professional	TC	$26.53	$31.57	$58.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $53.76 / $79.11	Professional		$41.24	$53.76	$79.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.15 / $15.30 / $23.07	Professional	26	$12.15	$15.30	$23.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.58 / $38.82 / $56.75	Professional	TC	$27.58	$38.82	$56.75
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $47.74 / $53.24 / $136.38	Professional		$47.74	$53.24	$136.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.87 / $14.87 / $18.88	Professional	26	$14.87	$14.87	$18.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.86 / $35.94 / $44.92	Professional	TC	$32.86	$35.94	$44.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.43 / $56.24 / $98.76	Professional		$37.43	$56.24	$98.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $17.46 / $29.90	Professional	26	$10.87	$17.46	$29.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.97 / $38.61 / $71.89	Professional	TC	$26.97	$38.61	$71.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.82 / $54.98 / $67.38	Professional		$45.82	$54.98	$67.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $14.90 / $17.95	Professional	26	$12.06	$14.90	$17.95
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 $19.92 / $24.00 / $41.51	Facility	26	$19.92	$24.00	$41.51
Medcost Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $43.00 / $78.00	Professional		$18.57	$43.00	$78.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $53.18 / $94.94	Professional		$19.14	$53.18	$94.94
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $14.04 / $19.11 / $30.25	Professional	26	$14.04	$19.11	$30.25
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $33.44 / $45.89 / $75.55	Professional	TC	$33.44	$45.89	$75.55
United Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $56.26 / $85.91	Professional		$37.04	$56.26	$85.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $17.18 / $27.62	Professional	26	$11.14	$17.18	$27.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.22 / $39.01 / $61.09	Professional	TC	$23.22	$39.01	$61.09