Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $13.80 / $44.67	Facility	26	$8.51	$13.80	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $131.83	Professional		$30.90	$48.98	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $16.60 / $32.36	Professional	26	$8.71	$16.60	$32.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.90 / $61.66	Professional	TC	$21.38	$30.90	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $50.12 / $77.62	Professional		$35.48	$50.12	$77.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.49 / $20.89	Professional	26	$9.77	$13.49	$20.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $56.23	Professional	TC	$25.70	$36.31	$56.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $114.82	Professional		$26.92	$44.67	$114.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $11.22 / $16.98	Professional	26	$10.00	$11.22	$16.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $29.51 / $50.12	Professional	TC	$29.51	$29.51	$50.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $81.28	Professional		$29.51	$43.65	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.75 / $22.91	Professional	26	$7.94	$11.75	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $58.88	Professional	TC	$21.88	$31.62	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $56.23	Professional		$38.02	$45.71	$56.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $11.75 / $15.14	Professional	26	$9.55	$11.75	$15.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $33.88 / $42.66	Professional	TC	$27.54	$33.88	$42.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $53.70 / $85.11	Professional		$43.65	$53.70	$85.11
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.60 / $23.44	Professional	26	$13.49	$16.60	$23.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $63.10	Professional		$39.81	$39.81	$63.10
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $40.74 / $162.18	Professional		$12.30	$40.74	$162.18
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.88 / $23.99	Professional	26	$9.55	$12.88	$23.99
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $35.48 / $61.66	Professional	TC	$26.30	$35.48	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $72.44	Professional		$26.92	$40.74	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.75 / $20.42	Professional	26	$7.59	$11.75	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.84 / $50.12	Professional	TC	$19.50	$28.84	$50.12