Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.22 / $10.24 / $31.10	Facility	26	$7.22	$10.24	$31.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.69 / $49.37 / $260.64	Facility	TC	$17.69	$49.37	$260.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.10 / $45.75	Professional		$21.88	$26.10	$45.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.39 / $7.64 / $12.48	Professional	26	$6.39	$7.64	$12.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.60 / $19.00 / $31.77	Professional	TC	$15.60	$19.00	$31.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.89 / $33.81 / $50.76	Professional		$25.89	$33.81	$50.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $9.26 / $14.10	Professional	26	$7.21	$9.26	$14.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $24.48 / $36.54	Professional	TC	$18.19	$24.48	$36.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $33.11 / $95.99	Professional		$30.55	$33.11	$95.99
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $9.51 / $12.08	Professional	26	$9.51	$9.51	$12.08
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.04 / $21.58 / $26.97	Professional	TC	$21.04	$21.58	$26.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.18 / $24.18 / $24.18	Facility	TC	$24.18	$24.18	$24.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.41 / $35.61 / $62.97	Professional		$23.41	$35.61	$62.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.64 / $17.66	Professional	26	$6.46	$10.64	$17.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.55 / $24.63 / $44.34	Professional	TC	$16.55	$24.63	$44.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $34.27 / $42.00	Professional		$28.56	$34.27	$42.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $8.98 / $10.72	Professional	26	$7.27	$8.98	$10.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.29 / $25.55 / $31.31	Professional	TC	$21.29	$25.55	$31.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.50 / $12.50 / $24.78	Facility	26	$12.50	$12.50	$24.78
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $23.85 / $26.34 / $62.65	Facility	TC	$23.85	$26.34	$62.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $27.00 / $50.14	Professional		$11.00	$27.00	$50.14
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.21 / $33.20 / $64.42	Professional		$11.21	$33.20	$64.42
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $11.44 / $18.12	Professional	26	$8.49	$11.44	$18.12
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $20.55 / $27.52 / $44.21	Professional	TC	$20.55	$27.52	$44.21
United Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $35.18 / $54.78	Professional		$23.16	$35.18	$54.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $10.18 / $17.09	Professional	26	$6.45	$10.18	$17.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.27 / $24.86 / $38.86	Professional	TC	$16.27	$24.86	$38.86