Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.59 / $17.07 / $32.65	Facility	26	$9.59	$17.07	$32.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.17 / $39.22 / $77.36	Professional		$33.17	$39.22	$77.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.98 / $10.19 / $21.60	Professional	26	$8.98	$10.19	$21.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.00 / $29.62 / $57.79	Professional	TC	$24.00	$29.62	$57.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.68 / $46.89 / $70.39	Professional		$36.68	$46.89	$70.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $12.24 / $18.46	Professional	26	$9.72	$12.24	$18.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.05 / $34.59 / $51.92	Professional	TC	$27.05	$34.59	$51.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.87 / $46.09 / $141.74	Professional		$45.87	$46.09	$141.74
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $13.09 / $16.62	Professional	26	$12.35	$13.09	$16.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $33.00 / $33.00 / $41.91	Professional	TC	$33.00	$33.00	$41.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $55.46 / $89.83	Professional		$32.70	$55.46	$89.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $13.97 / $23.97	Professional	26	$8.67	$13.97	$23.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.33 / $41.08 / $68.02	Professional	TC	$24.33	$41.08	$68.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $46.98 / $57.58	Professional		$39.15	$46.98	$57.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.94 / $14.39	Professional	26	$9.66	$11.94	$14.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $35.38 / $43.36	Professional	TC	$29.49	$35.38	$43.36
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.02 / $19.00 / $32.49	Facility	26	$16.02	$19.00	$32.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $48.00 / $75.00	Professional		$14.70	$48.00	$75.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $50.14 / $90.01	Professional		$15.09	$50.14	$90.01
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $15.57 / $24.18	Professional	26	$11.12	$15.57	$24.18
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $43.80 / $65.58	Professional	TC	$30.14	$43.80	$65.58
United Facility/Professional Professional Modifier Low / Median / High Price $31.77 / $47.65 / $85.19	Professional		$31.77	$47.65	$85.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $13.64 / $23.06	Professional	26	$8.42	$13.64	$23.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.58 / $35.71 / $60.15	Professional	TC	$22.58	$35.71	$60.15