Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.26 / $20.71 / $39.76	Facility	26	$12.26	$20.71	$39.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $40.92 / $71.75	Professional		$33.40	$40.92	$71.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $13.39 / $24.96	Professional	26	$11.50	$13.39	$24.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $27.64 / $50.91	Professional	TC	$23.29	$27.64	$50.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $49.28 / $75.87	Professional		$39.59	$49.28	$75.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $15.55 / $23.56	Professional	26	$12.32	$15.55	$23.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.01 / $33.97 / $49.79	Professional	TC	$26.01	$33.97	$49.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $44.38 / $48.08 / $135.36	Professional		$44.38	$48.08	$135.36
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.33 / $14.51 / $18.43	Professional	26	$14.33	$14.51	$18.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.87 / $33.57 / $38.52	Professional	TC	$29.87	$33.57	$38.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.80 / $15.80 / $15.80	Facility	26	$15.80	$15.80	$15.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $53.70 / $92.25	Professional		$34.65	$53.70	$92.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $17.42 / $30.93	Professional	26	$10.88	$17.42	$30.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.22 / $35.92 / $62.65	Professional	TC	$23.22	$35.92	$62.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $50.21 / $61.75	Professional		$41.85	$50.21	$61.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $15.26 / $18.38	Professional	26	$12.35	$15.26	$18.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $35.38 / $43.36	Professional	TC	$29.49	$35.38	$43.36
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.00 / $22.00 / $43.57	Facility	26	$18.00	$22.00	$43.57
Medcost Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $40.00 / $71.34	Professional		$18.00	$40.00	$71.34
Sentara Facility/Professional Professional Modifier Low / Median / High Price $18.63 / $50.11 / $96.63	Professional		$18.63	$50.11	$96.63
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.59 / $31.01	Professional	26	$13.80	$19.59	$31.01
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $29.75 / $40.70 / $65.58	Professional	TC	$29.75	$40.70	$65.58
United Facility/Professional Professional Modifier Low / Median / High Price $33.38 / $51.70 / $80.14	Professional		$33.38	$51.70	$80.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $16.59 / $27.29	Professional	26	$10.90	$16.59	$27.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.30 / $33.86 / $54.93	Professional	TC	$22.30	$33.86	$54.93