Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.60 / $12.32 / $27.82	Facility	26	$8.60	$12.32	$27.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.85 / $35.00 / $61.30	Professional		$29.85	$35.00	$61.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $9.71 / $22.73	Professional	26	$8.22	$9.71	$22.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.99 / $26.12 / $44.79	Professional	TC	$21.99	$26.12	$44.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.13 / $44.05 / $64.38	Professional		$33.13	$44.05	$64.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $11.98 / $17.77	Professional	26	$9.61	$11.98	$17.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.84 / $32.11 / $46.93	Professional	TC	$23.84	$32.11	$46.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $37.58 / $42.58 / $103.93	Professional		$37.58	$42.58	$103.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $10.03 / $12.73	Professional	26	$10.02	$10.03	$12.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.56 / $29.10 / $36.38	Professional	TC	$27.56	$29.10	$36.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.26 / $44.93 / $78.20	Professional		$30.26	$44.93	$78.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $12.23 / $22.96	Professional	26	$8.24	$12.23	$22.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.46 / $32.15 / $58.45	Professional	TC	$22.46	$32.15	$58.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $45.37 / $55.60	Professional		$37.81	$45.37	$55.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $11.90 / $14.33	Professional	26	$9.63	$11.90	$14.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.81 / $41.44	Professional	TC	$28.18	$33.81	$41.44
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.70 / $16.00 / $30.17	Facility	26	$13.70	$16.00	$30.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $36.00 / $62.00	Professional		$12.00	$36.00	$62.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.78 / $42.47 / $86.04	Professional		$13.78	$42.47	$86.04
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $14.08 / $24.18	Professional	26	$10.36	$14.08	$24.18
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $27.64 / $37.21 / $61.42	Professional	TC	$27.64	$37.21	$61.42
United Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $45.94 / $69.33	Professional		$30.24	$45.94	$69.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $13.28 / $22.41	Professional	26	$8.39	$13.28	$22.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $31.25 / $49.69	Professional	TC	$20.72	$31.25	$49.69