Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.07 / $16.60 / $36.93	Facility	26	$11.07	$16.60	$36.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.41 / $37.86 / $69.73	Professional		$30.41	$37.86	$69.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $12.36 / $24.22	Professional	26	$10.16	$12.36	$24.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.56 / $26.44 / $49.14	Professional	TC	$20.56	$26.44	$49.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $48.96 / $72.81	Professional		$36.69	$48.96	$72.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $14.28 / $21.81	Professional	26	$11.12	$14.28	$21.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.85 / $34.81 / $51.76	Professional	TC	$25.85	$34.81	$51.76
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $48.42 / $122.54	Professional		$42.50	$48.42	$122.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.85 / $15.02 / $19.07	Professional	26	$14.85	$15.02	$19.07
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.48 / $30.82 / $38.52	Professional	TC	$27.48	$30.82	$38.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.02 / $50.57 / $88.27	Professional		$33.02	$50.57	$88.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $16.51 / $27.65	Professional	26	$10.05	$16.51	$27.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.13 / $32.72 / $61.91	Professional	TC	$23.13	$32.72	$61.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $49.56 / $60.74	Professional		$41.30	$49.56	$60.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $13.78 / $16.59	Professional	26	$11.15	$13.78	$16.59
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 $19.79 / $19.79 / $39.38	Facility	26	$19.79	$19.79	$39.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $35.00 / $72.12	Professional		$17.00	$35.00	$72.12
Sentara Facility/Professional Professional Modifier Low / Median / High Price $17.57 / $46.40 / $82.17	Professional		$17.57	$46.40	$82.17
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $13.42 / $17.87 / $27.97	Professional	26	$13.42	$17.87	$27.97
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $27.93 / $39.22 / $63.14	Professional	TC	$27.93	$39.22	$63.14
United Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $50.24 / $82.00	Professional		$31.40	$50.24	$82.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $16.37 / $25.55	Professional	26	$10.61	$16.37	$25.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $33.86 / $53.12	Professional	TC	$22.11	$33.86	$53.12