Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.98 / $13.99 / $32.65	Facility	26	$8.98	$13.99	$32.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $33.34 / $61.18	Professional		$28.32	$33.34	$61.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $10.19 / $19.82	Professional	26	$8.42	$10.19	$19.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $23.59 / $42.63	Professional	TC	$19.57	$23.59	$42.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $38.90 / $59.77	Professional		$31.26	$38.90	$59.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $11.64 / $17.48	Professional	26	$9.01	$11.64	$17.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $27.68 / $42.53	Professional	TC	$22.13	$27.68	$42.53
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $40.42 / $114.06	Professional		$39.79	$40.42	$114.06
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.05 / $12.68 / $16.10	Professional	26	$12.05	$12.68	$16.10
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.74 / $27.74 / $35.22	Professional	TC	$27.74	$27.74	$35.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.56 / $11.56 / $11.56	Facility	26	$11.56	$11.56	$11.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.71 / $44.51 / $75.93	Professional		$27.71	$44.51	$75.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $13.47 / $23.86	Professional	26	$8.21	$13.47	$23.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $30.23 / $51.72	Professional	TC	$19.13	$30.23	$51.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $39.95 / $48.96	Professional		$33.29	$39.95	$48.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.03 / $11.17 / $13.46	Professional	26	$9.03	$11.17	$13.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $29.09 / $35.65	Professional	TC	$24.24	$29.09	$35.65
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.02 / $19.00 / $32.07	Facility	26	$16.02	$19.00	$32.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $35.00 / $57.98	Professional		$14.00	$35.00	$57.98
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.08 / $43.29 / $77.86	Professional		$15.08	$43.29	$77.86
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $14.99 / $23.76	Professional	26	$10.99	$14.99	$23.76
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $34.13 / $53.54	Professional	TC	$24.75	$34.13	$53.54
United Facility/Professional Professional Modifier Low / Median / High Price $27.47 / $41.21 / $67.34	Professional		$27.47	$41.21	$67.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $13.12 / $20.78	Professional	26	$7.98	$13.12	$20.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $27.86 / $45.20	Professional	TC	$18.57	$27.86	$45.20