Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $16.98 / $66.07	Facility	26	$7.94	$16.98	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $39.81 / $89.13	Professional		$28.18	$39.81	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $29.51	Professional	26	$7.94	$13.18	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $51.29	Professional	TC	$19.05	$25.70	$51.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $67.61	Professional		$32.36	$44.67	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.88 / $19.95	Professional	26	$9.33	$12.88	$19.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $48.98	Professional	TC	$22.91	$31.62	$48.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $38.90 / $114.82	Professional		$9.55	$38.90	$114.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.02 / $16.22	Professional	26	$10.96	$12.02	$16.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $28.84 / $36.31	Professional	TC	$25.70	$28.84	$36.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.45 / $11.48 / $16.22	Facility	26	$2.45	$11.48	$16.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $43.65 / $74.13	Professional		$27.54	$43.65	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $22.39	Professional	26	$8.13	$13.18	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $51.29	Professional	TC	$19.05	$30.20	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $51.29	Professional		$34.67	$41.69	$51.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.48 / $14.45	Professional	26	$9.33	$11.48	$14.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.20 / $37.15	Professional	TC	$24.55	$30.20	$37.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $58.88 / $75.86	Professional		$47.86	$58.88	$75.86
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.05 / $21.88	Professional	26	$15.49	$19.05	$21.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $56.23	Professional		$39.81	$39.81	$56.23
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $39.81 / $144.54	Professional		$14.13	$39.81	$144.54
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.45 / $23.99	Professional	26	$10.47	$14.45	$23.99
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $32.36 / $53.70	Professional	TC	$24.55	$32.36	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.90 / $69.18	Professional		$26.30	$38.90	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.30 / $21.88	Professional	26	$8.13	$12.30	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.54 / $46.77	Professional	TC	$18.20	$27.54	$46.77