Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.89 / $11.71 / $21.82	Facility	26	$6.89	$11.71	$21.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.89 / $27.63 / $49.45	Professional		$21.89	$27.63	$49.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $7.48 / $15.88	Professional	26	$6.55	$7.48	$15.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $155.69 / $155.69 / $155.69	Professional	50	$155.69	$155.69	$155.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.52 / $12.58 / $14.97	Professional	52	$10.52	$12.58	$14.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $20.64 / $36.88	Professional	TC	$16.73	$20.64	$36.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.28 / $32.11 / $47.21	Professional		$25.28	$32.11	$47.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $8.80 / $13.27	Professional	26	$6.91	$8.80	$13.27
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.89 / $48.27 / $74.42	Professional	50	$37.89	$48.27	$74.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.63 / $23.52 / $34.38	Professional	TC	$17.63	$23.52	$34.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $31.68 / $80.23	Professional		$31.68	$31.68	$80.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $8.53 / $10.85	Professional	26	$8.10	$8.53	$10.85
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $23.14 / $29.39	Professional	TC	$20.83	$23.14	$29.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.73 / $34.92 / $59.39	Professional		$22.73	$34.92	$59.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.20 / $10.19 / $17.48	Professional	26	$6.20	$10.19	$17.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.52 / $24.45 / $43.32	Professional	TC	$16.52	$24.45	$43.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.25 / $32.70 / $40.08	Professional		$27.25	$32.70	$40.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $8.57 / $10.33	Professional	26	$6.94	$8.57	$10.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.32 / $24.38 / $29.88	Professional	TC	$20.32	$24.38	$29.88
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $14.00 / $23.35	Facility	26	$11.13	$14.00	$23.35
Medcost Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $28.00 / $49.00	Professional		$10.19	$28.00	$49.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $33.47 / $63.35	Professional		$11.00	$33.47	$63.35
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $10.97 / $17.38	Professional	26	$8.06	$10.97	$17.38
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $28.13 / $46.00	Professional	TC	$20.25	$28.13	$46.00
United Facility/Professional Professional Modifier Low / Median / High Price $22.31 / $33.89 / $54.65	Professional		$22.31	$33.89	$54.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $9.90 / $15.41	Professional	26	$6.16	$9.90	$15.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.99 / $23.79 / $38.15	Professional	TC	$14.99	$23.79	$38.15