Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.36 / $14.88 / $28.87	Facility	26	$8.36	$14.88	$28.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.48 / $31.30 / $55.96	Professional		$27.48	$31.30	$55.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $9.24 / $18.53	Professional	26	$7.86	$9.24	$18.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $22.18 / $40.85	Professional	TC	$18.62	$22.18	$40.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.36 / $37.71 / $55.20	Professional		$30.36	$37.71	$55.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $10.81 / $16.07	Professional	26	$8.59	$10.81	$16.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.56 / $27.25 / $40.93	Professional	TC	$20.56	$27.25	$40.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.14 / $37.31 / $109.66	Professional		$34.14	$37.31	$109.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $10.38 / $13.18	Professional	26	$10.38	$10.38	$13.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $26.93 / $31.24	Professional	TC	$23.76	$26.93	$31.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $41.69 / $70.95	Professional		$26.52	$41.69	$70.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.54 / $21.31	Professional	26	$7.59	$12.54	$21.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $29.14 / $50.98	Professional	TC	$18.82	$29.14	$50.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.02 / $38.42 / $47.09	Professional		$32.02	$38.42	$47.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $10.41 / $12.54	Professional	26	$8.42	$10.41	$12.54
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 $14.24 / $17.00 / $30.03	Facility	26	$14.24	$17.00	$30.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $32.00 / $57.00	Professional		$13.00	$32.00	$57.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.59 / $38.65 / $66.05	Professional		$13.59	$38.65	$66.05
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.17 / $13.58 / $21.16	Professional	26	$10.17	$13.58	$21.16
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $24.03 / $33.04 / $52.29	Professional	TC	$24.03	$33.04	$52.29
United Facility/Professional Professional Modifier Low / Median / High Price $26.00 / $39.49 / $62.68	Professional		$26.00	$39.49	$62.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.49 / $12.25 / $19.47	Professional	26	$7.49	$12.25	$19.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $27.01 / $44.44	Professional	TC	$17.78	$27.01	$44.44