Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $14.89 / $34.57	Facility	26	$9.55	$14.89	$34.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $33.25 / $58.52	Professional		$23.86	$33.25	$58.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $9.44 / $17.47	Professional	26	$7.67	$9.44	$17.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.75 / $13.77 / $17.26	Professional	52	$11.75	$13.77	$17.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.91 / $23.69 / $41.03	Professional	TC	$15.91	$23.69	$41.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.15 / $34.19 / $50.74	Professional		$26.15	$34.19	$50.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $10.61 / $15.89	Professional	26	$8.11	$10.61	$15.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $23.36 / $34.99	Professional	TC	$18.03	$23.36	$34.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $42.17 / $112.00	Professional		$40.44	$42.17	$112.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $12.37 / $15.71	Professional	26	$11.17	$12.37	$15.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.56 / $29.80 / $41.72	Professional	TC	$28.56	$29.80	$41.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.55 / $42.68 / $69.58	Professional		$23.55	$42.68	$69.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $12.51 / $21.63	Professional	26	$7.42	$12.51	$21.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.93 / $30.24 / $48.70	Professional	TC	$16.93	$30.24	$48.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.83 / $33.39 / $40.93	Professional		$27.83	$33.39	$40.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $10.10 / $12.18	Professional	26	$8.18	$10.10	$12.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.66 / $23.59 / $28.91	Professional	TC	$19.66	$23.59	$28.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.21 / $17.00 / $30.33	Facility	26	$15.21	$17.00	$30.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $13.32 / $36.00 / $59.00	Professional		$13.32	$36.00	$59.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.59 / $41.50 / $66.03	Professional		$13.59	$41.50	$66.03
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $13.61 / $21.37	Professional	26	$10.15	$13.61	$21.37
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $34.75 / $46.91	Professional	TC	$21.78	$34.75	$46.91
United Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $37.76 / $63.45	Professional		$24.89	$37.76	$63.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $11.62 / $21.37	Professional	26	$7.65	$11.62	$21.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.37 / $26.77 / $49.41	Professional	TC	$17.37	$26.77	$49.41