Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.32 / $13.49 / $34.06	Facility	26	$7.32	$13.49	$34.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.89 / $33.96 / $54.10	Professional		$14.89	$33.96	$54.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $13.49 / $22.93	Professional	26	$7.32	$13.49	$22.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.57 / $20.80 / $36.04	Professional	TC	$7.57	$20.80	$36.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.53 / $47.78 / $69.84	Professional		$20.53	$47.78	$69.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $16.80 / $24.56	Professional	26	$8.86	$16.80	$24.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.06 / $30.98 / $45.29	Professional	TC	$12.06	$30.98	$45.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $19.22 / $51.61 / $85.92	Professional		$19.22	$51.61	$85.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $17.95 / $22.80	Professional	26	$8.53	$17.95	$22.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $10.68 / $33.51 / $42.56	Professional	TC	$10.68	$33.51	$42.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.66 / $31.62 / $83.23	Professional		$18.66	$31.62	$83.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $12.14 / $30.96	Professional	26	$8.11	$12.14	$30.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.65 / $20.32 / $52.71	Professional	TC	$10.65	$20.32	$52.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.11 / $49.33 / $60.23	Professional		$41.11	$49.33	$60.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $16.78 / $20.23	Professional	26	$13.58	$16.78	$20.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.52 / $33.03 / $40.00	Professional	TC	$27.52	$33.03	$40.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.76 / $14.00 / $27.76	Facility	26	$11.76	$14.00	$27.76
Medcost Facility/Professional Professional Modifier Low / Median / High Price $10.19 / $20.00 / $40.00	Professional		$10.19	$20.00	$40.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $30.03 / $92.78	Professional		$11.00	$30.03	$92.78
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $16.27 / $33.95	Professional	26	$9.34	$16.27	$33.95
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $13.09 / $27.12 / $58.83	Professional	TC	$13.09	$27.12	$58.83
United Facility/Professional Professional Modifier Low / Median / High Price $19.78 / $38.18 / $73.58	Professional		$19.78	$38.18	$73.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $13.47 / $27.42	Professional	26	$6.65	$13.47	$27.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.58 / $23.86 / $46.16	Professional	TC	$11.58	$23.86	$46.16