Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.87 / $16.57 / $41.78	Facility	26	$13.87	$16.57	$41.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $42.10 / $87.46	Professional		$35.65	$42.10	$87.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $13.87 / $22.68	Professional	26	$7.78	$13.87	$22.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.78 / $28.12 / $77.70	Professional	TC	$22.78	$28.12	$77.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.03 / $50.30 / $83.79	Professional		$39.03	$50.30	$83.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $16.45 / $24.00	Professional	26	$10.37	$16.45	$24.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.51 / $33.01 / $60.00	Professional	TC	$25.51	$33.01	$60.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.58 / $184.60	Professional		$54.95	$56.58	$184.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $13.95 / $17.44	Professional	26	$9.31	$13.95	$17.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $39.97 / $42.62 / $59.67	Professional	TC	$39.97	$42.62	$59.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $64.62 / $111.54	Professional		$34.59	$64.62	$111.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.72 / $13.03 / $31.71	Professional	26	$8.72	$13.03	$31.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $49.66 / $92.56	Professional	TC	$22.71	$49.66	$92.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.14 / $49.37 / $60.59	Professional		$41.14	$49.37	$60.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $16.82 / $20.81	Professional	26	$13.62	$16.82	$20.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.52 / $33.03 / $40.47	Professional	TC	$27.52	$33.03	$40.47
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $14.00 / $40.40	Facility	26	$12.29	$14.00	$40.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.03 / $58.00 / $136.00	Professional		$11.03	$58.00	$136.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.28 / $64.54 / $111.24	Professional		$14.28	$64.54	$111.24
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $16.82 / $33.82	Professional	26	$9.36	$16.82	$33.82
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $30.94 / $52.82 / $88.67	Professional	TC	$30.94	$52.82	$88.67
United Facility/Professional Professional Modifier Low / Median / High Price $34.07 / $58.45 / $96.19	Professional		$34.07	$58.45	$96.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $14.28 / $27.00	Professional	26	$7.45	$14.28	$27.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.46 / $43.80 / $82.92	Professional	TC	$22.46	$43.80	$82.92