Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.22 / $12.27 / $22.70	Facility	26	$7.22	$12.27	$22.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $28.94 / $54.36	Professional		$21.73	$28.94	$54.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $7.79 / $18.50	Professional	26	$6.95	$7.79	$18.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $22.48 / $40.85	Professional	TC	$18.32	$22.48	$40.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $36.58 / $53.47	Professional		$27.43	$36.58	$53.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $9.18 / $13.84	Professional	26	$7.21	$9.18	$13.84
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.14 / $55.00 / $84.48	Professional	50	$41.14	$55.00	$84.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $27.62 / $40.38	Professional	TC	$20.07	$27.62	$40.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.06 / $36.25 / $86.12	Professional		$32.06	$36.25	$86.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $8.94 / $11.37	Professional	26	$8.49	$8.94	$11.37
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.11 / $24.66 / $30.82	Professional	TC	$23.11	$24.66	$30.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $36.84 / $66.03	Professional		$25.02	$36.84	$66.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.37 / $18.03	Professional	26	$6.46	$10.37	$18.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $26.17 / $49.52	Professional	TC	$18.57	$26.17	$49.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.51 / $37.81 / $46.34	Professional		$31.51	$37.81	$46.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $8.98 / $10.82	Professional	26	$7.27	$8.98	$10.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $29.09 / $35.65	Professional	TC	$24.24	$29.09	$35.65
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.11 / $13.00 / $24.78	Facility	26	$12.11	$13.00	$24.78
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $29.00 / $50.00	Professional		$11.00	$29.00	$50.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $34.44 / $70.90	Professional		$11.00	$34.44	$70.90
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $11.34 / $18.12	Professional	26	$8.06	$11.34	$18.12
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $22.59 / $30.54 / $51.83	Professional	TC	$22.59	$30.54	$51.83
United Facility/Professional Professional Modifier Low / Median / High Price $24.42 / $37.15 / $57.17	Professional		$24.42	$37.15	$57.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.51 / $9.98 / $16.18	Professional	26	$6.51	$9.98	$16.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $26.20 / $41.58	Professional	TC	$17.91	$26.20	$41.58