Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.88 / $11.03 / $38.15	Facility	26	$9.88	$11.03	$38.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.53 / $226.28 / $363.79	Facility	TC	$20.53	$226.28	$363.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $32.84 / $60.45	Professional		$28.03	$32.84	$60.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.40 / $10.51 / $19.68	Professional	26	$9.40	$10.51	$19.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $22.75 / $43.65	Professional	TC	$19.89	$22.75	$43.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $42.20 / $63.22	Professional		$30.51	$42.20	$63.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $12.30 / $18.88	Professional	26	$9.61	$12.30	$18.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $29.83 / $44.37	Professional	TC	$20.17	$29.83	$44.37
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $41.60 / $115.62	Professional		$39.38	$41.60	$115.62
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.83 / $13.01 / $16.52	Professional	26	$12.83	$13.01	$16.52
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.37 / $26.37 / $32.96	Professional	TC	$26.37	$26.37	$32.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $42.60 / $76.18	Professional		$28.39	$42.60	$76.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $14.23 / $24.25	Professional	26	$8.69	$14.23	$24.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.86 / $27.96 / $52.96	Professional	TC	$19.86	$27.96	$52.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $42.62 / $52.23	Professional		$35.51	$42.62	$52.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $12.30 / $14.78	Professional	26	$9.94	$12.30	$14.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.56 / $30.67 / $37.59	Professional	TC	$25.56	$30.67	$37.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.94 / $20.13 / $34.19	Facility	26	$12.94	$20.13	$34.19
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $29.85 / $30.54 / $59.83	Facility	TC	$29.85	$30.54	$59.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $41.63 / $65.12	Professional		$17.00	$41.63	$65.12
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.47 / $40.45 / $79.16	Professional		$15.47	$40.45	$79.16
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $15.75 / $24.94	Professional	26	$11.81	$15.75	$24.94
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $33.64 / $54.02	Professional	TC	$24.23	$33.64	$54.02
United Facility/Professional Professional Modifier Low / Median / High Price $28.90 / $42.65 / $65.67	Professional		$28.90	$42.65	$65.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $14.22 / $21.59	Professional	26	$9.27	$14.22	$21.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.17 / $29.14 / $44.06	Professional	TC	$19.17	$29.14	$44.06