Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.83 / $11.09 / $25.37	Facility	26	$7.83	$11.09	$25.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.69 / $28.48 / $49.81	Professional		$19.69	$28.48	$49.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.29 / $8.27 / $16.67	Professional	26	$7.29	$8.27	$16.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $113.57 / $113.57 / $130.00	Professional	50	$113.57	$113.57	$130.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.27 / $19.46 / $34.67	Professional	TC	$12.27	$19.46	$34.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.64 / $27.80 / $42.00	Professional		$21.64	$27.80	$42.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $9.85 / $15.00	Professional	26	$7.81	$9.85	$15.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.47 / $41.32 / $62.58	Professional	50	$32.47	$41.32	$62.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $18.03 / $26.65	Professional	TC	$13.83	$18.03	$26.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.38 / $33.61 / $88.31	Professional		$32.38	$33.61	$88.31
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $10.49 / $13.32	Professional	26	$9.44	$10.49	$13.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.89 / $23.12 / $31.60	Professional	TC	$21.89	$23.12	$31.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.53 / $35.22 / $57.14	Professional		$19.53	$35.22	$57.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $11.16 / $19.57	Professional	26	$6.99	$11.16	$19.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.96 / $23.40 / $38.89	Professional	TC	$12.96	$23.40	$38.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $27.54 / $33.85	Professional		$22.95	$27.54	$33.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $9.73 / $11.75	Professional	26	$7.88	$9.73	$11.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $15.07 / $18.07 / $22.16	Professional	TC	$15.07	$18.07	$22.16
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $15.00 / $26.82	Facility	26	$12.63	$15.00	$26.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $30.00 / $49.00	Professional		$12.00	$30.00	$49.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.01 / $34.09 / $53.58	Professional		$12.01	$34.09	$53.58
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $12.50 / $19.64	Professional	26	$8.73	$12.50	$19.64
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $27.10 / $37.22	Professional	TC	$17.51	$27.10	$37.22
United Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $33.47 / $53.27	Professional		$21.60	$33.47	$53.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.15 / $11.19 / $16.91	Professional	26	$7.15	$11.19	$16.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.57 / $23.25 / $37.44	Professional	TC	$14.57	$23.25	$37.44