Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $16.23 / $29.40	Facility	26	$9.55	$16.23	$29.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.31 / $37.56 / $66.17	Professional		$32.31	$37.56	$66.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $10.19 / $22.82	Professional	26	$9.15	$10.19	$22.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.42 / $26.42 / $48.12	Professional	TC	$22.42	$26.42	$48.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.77 / $44.43 / $68.40	Professional		$35.77	$44.43	$68.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $12.24 / $18.39	Professional	26	$9.61	$12.24	$18.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.24 / $32.47 / $49.49	Professional	TC	$25.24	$32.47	$49.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $43.60 / $122.02	Professional		$40.46	$43.60	$122.02
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 $28.96 / $32.09 / $36.78	Professional	TC	$28.96	$32.09	$36.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $48.10 / $82.34	Professional		$30.65	$48.10	$82.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $13.90 / $23.86	Professional	26	$8.64	$13.90	$23.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $34.06 / $59.24	Professional	TC	$22.80	$34.06	$59.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $45.37 / $55.60	Professional		$37.81	$45.37	$55.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $11.90 / $14.33	Professional	26	$9.63	$11.90	$14.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.81 / $41.44	Professional	TC	$28.18	$33.81	$41.44
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.78 / $19.00 / $34.19	Facility	26	$15.78	$19.00	$34.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $38.00 / $67.00	Professional		$14.00	$38.00	$67.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.08 / $45.47 / $86.04	Professional		$15.08	$45.47	$86.04
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $15.27 / $24.18	Professional	26	$10.99	$15.27	$24.18
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $28.44 / $39.06 / $61.85	Professional	TC	$28.44	$39.06	$61.85
United Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $46.37 / $75.23	Professional		$30.91	$46.37	$75.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $13.92 / $21.74	Professional	26	$8.89	$13.92	$21.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.43 / $32.15 / $53.22	Professional	TC	$21.43	$32.15	$53.22