Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $16.22 / $64.57	Facility	26	$7.94	$16.22	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.02 / $85.11	Professional		$22.91	$38.02	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.48 / $30.20	Professional	26	$7.08	$11.48	$30.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $33.88 / $54.95	Professional	52	$30.20	$33.88	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.44 / $51.29	Professional	TC	$15.14	$23.44	$51.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $58.88	Professional		$26.92	$38.02	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.75 / $18.20	Professional	26	$8.51	$11.75	$18.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.30 / $40.74	Professional	TC	$18.62	$26.30	$40.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $33.11 / $125.89	Professional		$9.55	$33.11	$125.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.00 / $13.80	Professional	26	$8.71	$10.00	$13.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $22.91 / $33.11	Professional	TC	$20.89	$22.91	$33.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.66 / $69.18	Professional		$24.55	$42.66	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.30 / $20.42	Professional	26	$7.41	$12.30	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $29.51 / $48.98	Professional	TC	$16.98	$29.51	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $35.48 / $43.65	Professional		$29.51	$35.48	$43.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.72 / $13.49	Professional	26	$8.71	$10.72	$13.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.12 / $30.90	Professional	TC	$20.42	$25.12	$30.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $61.66	Professional		$46.77	$57.54	$61.66
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $17.78 / $19.50	Professional	26	$14.45	$17.78	$19.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $45.71	Professional		$39.81	$39.81	$45.71
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $37.15 / $91.20	Professional		$12.88	$37.15	$91.20
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $21.88	Professional	26	$9.33	$13.49	$21.88
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $48.98	Professional	TC	$19.95	$32.36	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $67.61	Professional		$25.12	$38.02	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.72 / $19.50	Professional	26	$7.41	$10.72	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.30 / $47.86	Professional	TC	$17.38	$26.30	$47.86