Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.26 / $16.87 / $35.85	Facility	26	$9.26	$16.87	$35.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.19 / $37.63 / $69.76	Professional		$28.19	$37.63	$69.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $9.88 / $18.14	Professional	26	$8.46	$9.88	$18.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.63 / $27.69 / $52.82	Professional	TC	$20.63	$27.69	$52.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.49 / $46.29 / $67.78	Professional		$35.49	$46.29	$67.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $11.91 / $17.95	Professional	26	$9.44	$11.91	$17.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.73 / $34.72 / $50.75	Professional	TC	$24.73	$34.72	$50.75
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.09 / $45.81 / $118.76	Professional		$40.09	$45.81	$118.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $11.50 / $14.61	Professional	26	$11.50	$11.50	$14.61
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $31.84 / $39.79	Professional	TC	$28.59	$31.84	$39.79
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 $32.00 / $48.58 / $85.14	Professional		$32.00	$48.58	$85.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $13.90 / $23.45	Professional	26	$8.41	$13.90	$23.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $34.15 / $63.19	Professional	TC	$23.89	$34.15	$63.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $47.38 / $58.06	Professional		$39.47	$47.38	$58.06
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 $30.14 / $36.17 / $44.33	Professional	TC	$30.14	$36.17	$44.33
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.78 / $18.00 / $33.13	Facility	26	$15.78	$18.00	$33.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $38.00 / $66.00	Professional		$14.21	$38.00	$66.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $45.47 / $81.06	Professional		$15.05	$45.47	$81.06
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.05 / $14.85 / $23.42	Professional	26	$11.05	$14.85	$23.42
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $29.90 / $40.63 / $66.42	Professional	TC	$29.90	$40.63	$66.42
United Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $48.07 / $74.18	Professional		$31.36	$48.07	$74.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $13.05 / $20.93	Professional	26	$8.47	$13.05	$20.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $33.78 / $51.97	Professional	TC	$22.40	$33.78	$51.97