Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.70 / $9.68 / $18.02	Facility	26	$5.70	$9.68	$18.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.71 / $275.50 / $355.68	Facility	TC	$22.71	$275.50	$355.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $28.19 / $50.56	Professional		$21.26	$28.19	$50.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.40 / $6.17 / $12.96	Professional	26	$5.40	$6.17	$12.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.43 / $22.71 / $39.53	Professional	TC	$18.43	$22.71	$39.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $32.86 / $48.01	Professional		$24.98	$32.86	$48.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.71 / $7.21 / $10.98	Professional	26	$5.71	$7.21	$10.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.69 / $25.72 / $37.65	Professional	TC	$18.69	$25.72	$37.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.09 / $34.09 / $70.11	Professional		$34.09	$34.09	$70.11
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $7.07 / $8.98	Professional	26	$6.62	$7.07	$8.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $27.02 / $34.32	Professional	TC	$24.32	$27.02	$34.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.43 / $34.24 / $60.33	Professional		$22.43	$34.24	$60.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.09 / $8.36 / $14.51	Professional	26	$5.09	$8.36	$14.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.90 / $47.38	Professional	TC	$17.38	$25.90	$47.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.02 / $33.61 / $41.20	Professional		$28.02	$33.61	$41.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $5.74 / $7.09 / $8.56	Professional	26	$5.74	$7.09	$8.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $26.73 / $32.76	Professional	TC	$22.28	$26.73	$32.76
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $9.18 / $11.00 / $19.59	Facility	26	$9.18	$11.00	$19.59
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $25.71 / $30.58 / $68.39	Facility	TC	$25.71	$30.58	$68.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $8.41 / $32.00 / $51.00	Professional		$8.41	$32.00	$51.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $8.97 / $33.86 / $64.09	Professional		$8.97	$33.86	$64.09
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $6.59 / $9.05 / $14.33	Professional	26	$6.59	$9.05	$14.33
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $30.86 / $49.78	Professional	TC	$21.58	$30.86	$49.78
United Facility/Professional Professional Modifier Low / Median / High Price $21.17 / $31.39 / $53.83	Professional		$21.17	$31.39	$53.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.05 / $8.02 / $12.77	Professional	26	$5.05	$8.02	$12.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.27 / $23.56 / $40.57	Professional	TC	$16.27	$23.56	$40.57