Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.67 / $12.75 / $46.12	Facility	26	$11.67	$12.75	$46.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.75 / $280.12 / $541.91	Facility	TC	$22.75	$280.12	$541.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $37.54 / $63.78	Professional		$31.63	$37.54	$63.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $12.67 / $20.18	Professional	26	$10.61	$12.67	$20.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $25.40 / $40.46	Professional	TC	$20.77	$25.40	$40.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.49 / $48.69 / $72.30	Professional		$36.49	$48.69	$72.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $14.96 / $22.50	Professional	26	$11.72	$14.96	$22.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.63 / $33.65 / $50.05	Professional	TC	$24.63	$33.65	$50.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.95 / $48.14 / $244.25	Professional		$45.95	$48.14	$244.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $15.68 / $15.82 / $20.09	Professional	26	$15.68	$15.82	$20.09
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.13 / $30.13 / $37.65	Professional	TC	$30.13	$30.13	$37.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $50.76 / $89.28	Professional		$33.04	$50.76	$89.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $17.36 / $29.38	Professional	26	$10.53	$17.36	$29.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.65 / $31.82 / $60.53	Professional	TC	$22.65	$31.82	$60.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $48.34 / $59.24	Professional		$40.28	$48.34	$59.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $14.54 / $17.50	Professional	26	$11.77	$14.54	$17.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $34.21 / $41.93	Professional	TC	$28.51	$34.21	$41.93
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.30 / $22.38 / $40.44	Facility	26	$15.30	$22.38	$40.44
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $34.28 / $35.07 / $67.80	Facility	TC	$34.28	$35.07	$67.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $48.73 / $75.00	Professional		$20.00	$48.73	$75.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $47.35 / $90.83	Professional		$18.60	$47.35	$90.83
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $14.31 / $18.75 / $29.49	Professional	26	$14.31	$18.75	$29.49
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $27.51 / $38.46 / $61.73	Professional	TC	$27.51	$38.46	$61.73
United Facility/Professional Professional Modifier Low / Median / High Price $32.79 / $49.50 / $77.70	Professional		$32.79	$49.50	$77.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $16.80 / $29.22	Professional	26	$11.07	$16.80	$29.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.28 / $32.51 / $49.92	Professional	TC	$20.28	$32.51	$49.92