Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.45 / $23.94 / $53.20	Facility	26	$13.45	$23.94	$53.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.57 / $39.45 / $74.16	Professional		$33.57	$39.45	$74.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $14.64 / $29.36	Professional	26	$12.37	$14.64	$29.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $25.17 / $49.37	Professional	TC	$20.53	$25.17	$49.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.27 / $48.73 / $80.56	Professional		$37.27	$48.73	$80.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $17.38 / $25.87	Professional	26	$13.53	$17.38	$25.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.12 / $31.05 / $51.33	Professional	TC	$23.12	$31.05	$51.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.77 / $45.44 / $175.22	Professional		$43.77	$45.44	$175.22
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $16.30 / $20.70	Professional	26	$16.30	$16.30	$20.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.48 / $29.15 / $45.35	Professional	TC	$27.48	$29.15	$45.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $59.82 / $100.56	Professional		$32.08	$59.82	$100.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $19.97 / $33.72	Professional	26	$12.14	$19.97	$33.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $38.77 / $67.18	Professional	TC	$20.70	$38.77	$67.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $47.32 / $58.36	Professional		$39.43	$47.32	$58.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $16.73 / $20.17	Professional	26	$13.55	$16.73	$20.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.88 / $31.06 / $38.06	Professional	TC	$25.88	$31.06	$38.06
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.01 / $27.00 / $46.76	Facility	26	$23.01	$27.00	$46.76
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.82 / $44.00 / $96.00	Professional		$20.82	$44.00	$96.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $21.12 / $52.55 / $94.00	Professional		$21.12	$52.55	$94.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $16.13 / $21.49 / $33.29	Professional	26	$16.13	$21.49	$33.29
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $26.45 / $39.40 / $58.20	Professional	TC	$26.45	$39.40	$58.20
United Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $55.16 / $87.90	Professional		$33.93	$55.16	$87.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $19.00 / $30.31	Professional	26	$12.13	$19.00	$30.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.42 / $34.08 / $58.33	Professional	TC	$19.42	$34.08	$58.33