Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.86 / $16.73 / $31.64	Facility	26	$9.86	$16.73	$31.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $40.38 / $71.61	Professional		$34.59	$40.38	$71.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $10.89 / $20.92	Professional	26	$9.75	$10.89	$20.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $28.95 / $51.90	Professional	TC	$23.72	$28.95	$51.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $47.41 / $69.30	Professional		$35.65	$47.41	$69.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.82 / $13.47 / $19.68	Professional	26	$10.82	$13.47	$19.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.91 / $33.97 / $49.65	Professional	TC	$24.91	$33.97	$49.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.02 / $48.02 / $113.03	Professional		$48.02	$48.02	$113.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.32 / $15.65	Professional	26	$11.22	$12.32	$15.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.13 / $35.70 / $45.34	Professional	TC	$32.13	$35.70	$45.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.86 / $13.86 / $13.86	Facility	26	$13.86	$13.86	$13.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $50.01 / $86.72	Professional		$33.36	$50.01	$86.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $14.08 / $25.54	Professional	26	$9.30	$14.08	$25.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.08 / $36.43 / $61.91	Professional	TC	$24.08	$36.43	$61.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.35 / $48.42 / $59.35	Professional		$40.35	$48.42	$59.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.86 / $13.42 / $16.18	Professional	26	$10.86	$13.42	$16.18
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 $15.50 / $18.00 / $37.25	Facility	26	$15.50	$18.00	$37.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $42.00 / $71.34	Professional		$14.44	$42.00	$71.34
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.35 / $49.27 / $92.08	Professional		$15.35	$49.27	$92.08
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $15.89 / $27.21	Professional	26	$11.66	$15.89	$27.21
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $29.83 / $40.97 / $64.73	Professional	TC	$29.83	$40.97	$64.73
United Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $48.95 / $81.40	Professional		$30.59	$48.95	$81.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $14.15 / $22.38	Professional	26	$9.34	$14.15	$22.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $33.44 / $52.73	Professional	TC	$22.01	$33.44	$52.73