Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $9.01 / $34.99	Facility	26	$8.11	$9.01	$34.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.69 / $182.88 / $365.75	Facility	TC	$23.69	$182.88	$365.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.26 / $29.35 / $56.11	Professional		$23.26	$29.35	$56.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $8.59 / $17.25	Professional	26	$7.58	$8.59	$17.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.09 / $21.54 / $42.04	Professional	TC	$18.09	$21.54	$42.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.21 / $37.86 / $56.31	Professional		$28.21	$37.86	$56.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $10.42 / $15.89	Professional	26	$8.11	$10.42	$15.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $27.55 / $40.94	Professional	TC	$20.22	$27.55	$40.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $37.25 / $105.29	Professional		$32.86	$37.25	$105.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $10.69 / $13.58	Professional	26	$10.69	$10.69	$13.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.17 / $23.97 / $29.96	Professional	TC	$22.17	$23.97	$29.96
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 Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $38.61 / $67.56	Professional		$25.43	$38.61	$67.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $11.98 / $19.88	Professional	26	$7.28	$11.98	$19.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $25.92 / $48.14	Professional	TC	$18.05	$25.92	$48.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $38.52 / $47.20	Professional		$32.10	$38.52	$47.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $10.10 / $12.07	Professional	26	$8.18	$10.10	$12.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.92 / $28.70 / $35.18	Professional	TC	$23.92	$28.70	$35.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $14.07 / $14.07 / $27.88	Facility	26	$14.07	$14.07	$27.88
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.83 / $27.33 / $64.95	Facility	TC	$26.83	$27.33	$64.95
Medcost Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $29.00 / $56.42	Professional		$12.00	$29.00	$56.42
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $35.34 / $69.93	Professional		$12.62	$35.34	$69.93
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.56 / $12.88 / $20.39	Professional	26	$9.56	$12.88	$20.39
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $30.58 / $49.11	Professional	TC	$22.02	$30.58	$49.11
United Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $38.20 / $58.38	Professional		$25.15	$38.20	$58.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $11.62 / $19.23	Professional	26	$7.56	$11.62	$19.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.50 / $26.58 / $40.98	Professional	TC	$17.50	$26.58	$40.98