Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.26 / $16.48 / $41.34	Facility	26	$9.26	$16.48	$41.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.09 / $35.04 / $65.97	Professional		$29.09	$35.04	$65.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $11.47 / $20.99	Professional	26	$8.93	$11.47	$20.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.21 / $24.53 / $47.38	Professional	TC	$21.21	$24.53	$47.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $42.68 / $65.19	Professional		$33.97	$42.68	$65.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $12.18 / $18.23	Professional	26	$9.31	$12.18	$18.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $30.61 / $47.13	Professional	TC	$24.54	$30.61	$47.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $42.97 / $132.15	Professional		$42.97	$42.97	$132.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $13.39 / $17.01	Professional	26	$13.39	$13.39	$17.01
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.58 / $29.58 / $37.57	Professional	TC	$29.58	$29.58	$37.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.12 / $49.94 / $84.81	Professional		$30.12	$49.94	$84.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $14.64 / $25.71	Professional	26	$8.48	$14.64	$25.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $34.32 / $58.84	Professional	TC	$21.61	$34.32	$58.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.20 / $43.44 / $53.24	Professional		$36.20	$43.44	$53.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.53 / $13.90	Professional	26	$9.33	$11.53	$13.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.87 / $32.24 / $39.51	Professional	TC	$26.87	$32.24	$39.51
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $17.51 / $21.00 / $35.72	Facility	26	$17.51	$21.00	$35.72
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $38.06 / $64.27	Professional		$16.00	$38.06	$64.27
Sentara Facility/Professional Professional Modifier Low / Median / High Price $16.43 / $45.95 / $83.55	Professional		$16.43	$45.95	$83.55
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.51 / $15.87 / $23.47	Professional	26	$11.51	$15.87	$23.47
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $27.46 / $37.61 / $58.93	Professional	TC	$27.46	$37.61	$58.93
United Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $44.22 / $76.68	Professional		$29.29	$44.22	$76.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $13.78 / $21.47	Professional	26	$8.67	$13.78	$21.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $31.76 / $51.80	Professional	TC	$20.30	$31.76	$51.80