Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $13.34 / $24.68	Facility	26	$7.50	$13.34	$24.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.27 / $28.77 / $52.95	Professional		$23.27	$28.77	$52.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $7.96 / $14.15	Professional	26	$6.64	$7.96	$14.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $21.54 / $38.60	Professional	TC	$16.75	$21.54	$38.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $36.21 / $55.75	Professional		$29.14	$36.21	$55.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $9.56 / $14.43	Professional	26	$7.51	$9.56	$14.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $26.88 / $39.47	Professional	TC	$20.65	$26.88	$39.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $34.65 / $101.87	Professional		$34.65	$34.65	$101.87
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $9.31 / $11.82	Professional	26	$9.27	$9.31	$11.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $25.35 / $32.19	Professional	TC	$25.35	$25.35	$32.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $39.81 / $69.04	Professional		$25.39	$39.81	$69.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $10.91 / $18.75	Professional	26	$6.74	$10.91	$18.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $28.66 / $50.87	Professional	TC	$18.88	$28.66	$50.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.14 / $37.36 / $45.80	Professional		$31.14	$37.36	$45.80
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 $23.59 / $28.31 / $34.69	Professional	TC	$23.59	$28.31	$34.69
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 / $32.00 / $56.00	Professional		$11.09	$32.00	$56.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.82 / $36.53 / $63.57	Professional		$11.82	$36.53	$63.57
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $11.92 / $18.88	Professional	26	$8.80	$11.92	$18.88
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $23.93 / $32.56 / $51.45	Professional	TC	$23.93	$32.56	$51.45
United Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $37.33 / $59.51	Professional		$24.89	$37.33	$59.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.72 / $10.58 / $17.30	Professional	26	$6.72	$10.58	$17.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $26.58 / $44.16	Professional	TC	$17.72	$26.58	$44.16