Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.55 / $13.43 / $26.39	Facility	26	$7.55	$13.43	$26.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $36.21 / $64.34	Professional		$30.51	$36.21	$64.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $7.95 / $15.29	Professional	26	$7.01	$7.95	$15.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $28.41 / $51.03	Professional	TC	$22.26	$28.41	$51.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.69 / $44.77 / $65.48	Professional		$31.69	$44.77	$65.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $9.39 / $13.90	Professional	26	$7.37	$9.39	$13.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.53 / $67.20 / $98.39	Professional	50	$47.53	$67.20	$98.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $35.77 / $52.39	Professional	TC	$23.44	$35.77	$52.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $45.97 / $85.33	Professional		$40.65	$45.97	$85.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $10.89 / $13.83	Professional	26	$9.80	$10.89	$13.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $29.76 / $32.86 / $41.08	Professional	TC	$29.76	$32.86	$41.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.10 / $42.08 / $82.07	Professional		$29.10	$42.08	$82.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $10.91 / $18.85	Professional	26	$6.60	$10.91	$18.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.30 / $31.38 / $66.04	Professional	TC	$21.30	$31.38	$66.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $46.46 / $56.94	Professional		$38.72	$46.46	$56.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.38 / $11.32	Professional	26	$7.59	$9.38	$11.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.13 / $37.35 / $45.78	Professional	TC	$31.13	$37.35	$45.78
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.89 / $15.00 / $26.10	Facility	26	$12.89	$15.00	$26.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.08 / $35.00 / $64.00	Professional		$11.08	$35.00	$64.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.01 / $41.28 / $89.78	Professional		$12.01	$41.28	$89.78
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $12.41 / $18.89	Professional	26	$8.80	$12.41	$18.89
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $26.69 / $39.95 / $69.73	Professional	TC	$26.69	$39.95	$69.73
United Facility/Professional Professional Modifier Low / Median / High Price $26.96 / $42.33 / $71.53	Professional		$26.96	$42.33	$71.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.79 / $10.64 / $18.04	Professional	26	$6.79	$10.64	$18.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.89 / $31.48 / $60.50	Professional	TC	$18.89	$31.48	$60.50