Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.60 / $11.21 / $21.74	Facility	26	$6.60	$11.21	$21.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.89 / $42.58 / $309.60	Facility	TC	$13.89	$42.58	$309.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.95 / $21.21 / $40.61	Professional		$17.95	$21.21	$40.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.32 / $16.12	Professional	26	$6.17	$7.32	$16.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.78 / $14.16 / $27.73	Professional	TC	$11.78	$14.16	$27.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.54 / $24.91 / $38.10	Professional		$19.54	$24.91	$38.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.40 / $12.75	Professional	26	$6.61	$8.40	$12.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $29.31 / $37.36 / $57.15	Professional	50	$29.31	$37.36	$57.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.92 / $16.52 / $25.08	Professional	TC	$12.92	$16.52	$25.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $26.07 / $26.07 / $79.20	Professional		$26.07	$26.07	$79.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $8.19 / $10.40	Professional	26	$8.11	$8.19	$10.40
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $17.88 / $17.88 / $22.71	Professional	TC	$17.88	$17.88	$22.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.52 / $29.96 / $51.32	Professional		$17.52	$29.96	$51.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $9.59 / $16.59	Professional	26	$5.92	$9.59	$16.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.66 / $20.20 / $33.31	Professional	TC	$11.66	$20.20	$33.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.73 / $24.88 / $30.53	Professional		$20.73	$24.88	$30.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $8.21 / $9.90	Professional	26	$6.65	$8.21	$9.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $14.08 / $16.89 / $20.71	Professional	TC	$14.08	$16.89	$20.71
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.61 / $13.00 / $22.72	Facility	26	$10.61	$13.00	$22.72
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $16.01 / $25.92 / $47.78	Facility	TC	$16.01	$25.92	$47.78
Medcost Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $23.98 / $38.00	Professional		$10.00	$23.98	$38.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.30 / $28.20 / $49.29	Professional		$10.30	$28.20	$49.29
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $10.70 / $16.62	Professional	26	$7.65	$10.70	$16.62
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $14.44 / $21.45 / $31.51	Professional	TC	$14.44	$21.45	$31.51
United Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $25.79 / $44.30	Professional		$17.14	$25.79	$44.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $9.32 / $15.91	Professional	26	$5.92	$9.32	$15.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.84 / $17.38 / $28.87	Professional	TC	$10.84	$17.38	$28.87