Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $18.20 / $61.66	Facility	26	$12.88	$18.20	$61.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $70.79 / $346.74	Facility	TC	$29.51	$70.79	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $43.65 / $93.33	Professional		$33.88	$43.65	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $46.77	Professional	26	$12.02	$15.14	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $58.88	Professional	TC	$20.89	$28.84	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $58.88 / $89.13	Professional		$41.69	$58.88	$89.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.05 / $28.84	Professional	26	$13.49	$19.05	$28.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $39.81 / $61.66	Professional	TC	$28.18	$39.81	$61.66
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $269.15	Professional		$32.36	$51.29	$269.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $15.49 / $22.39	Professional	26	$14.13	$15.49	$22.39
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $54.95	Professional	TC	$35.48	$35.48	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.63 / $16.98 / $23.99	Facility	26	$3.63	$16.98	$23.99
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.24 / $33.88 / $47.86	Facility	TC	$7.24	$33.88	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $53.70 / $95.50	Professional		$35.48	$53.70	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $18.62 / $33.11	Professional	26	$11.48	$18.62	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $64.57	Professional	TC	$22.91	$32.36	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $66.07	Professional		$43.65	$52.48	$66.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.98 / $20.42	Professional	26	$13.49	$16.98	$20.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $36.31 / $44.67	Professional	TC	$29.51	$36.31	$44.67
Medcost Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Professional	26	$32.36	$32.36	$32.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $75.86	Professional		$37.15	$37.15	$75.86
Sentara Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $46.77 / $147.91	Professional		$19.50	$46.77	$147.91
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $20.42 / $33.88	Professional	26	$15.49	$20.42	$33.88
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $35.48 / $66.07	Professional	TC	$25.70	$35.48	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.12 / $85.11	Professional		$33.11	$50.12	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.20 / $32.36	Professional	26	$12.02	$18.20	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $53.70	Professional	TC	$20.42	$31.62	$53.70