Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.52 / $41.68 / $77.08	Facility	26	$24.52	$41.68	$77.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.62 / $56.16 / $126.37	Professional		$50.62	$56.16	$126.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $26.83 / $57.55	Professional	26	$24.20	$26.83	$57.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.01 / $31.27 / $87.05	Professional	TC	$26.01	$31.27	$87.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.01 / $70.34 / $106.50	Professional		$55.01	$70.34	$106.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $31.34 / $43.70	Professional	26	$24.89	$31.34	$43.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.76 / $38.51 / $63.17	Professional	TC	$29.76	$38.51	$63.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $82.07 / $84.53 / $287.77	Professional		$82.07	$84.53	$287.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.02 / $37.79 / $71.44	Professional	26	$34.02	$37.79	$71.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $46.66 / $46.73 / $88.74	Professional	TC	$46.66	$46.73	$88.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $90.82 / $153.58	Professional		$48.72	$90.82	$153.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.13 / $35.72 / $64.86	Professional	26	$22.13	$35.72	$64.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $48.78 / $94.46	Professional	TC	$25.70	$48.78	$94.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.47 / $70.98 / $85.80	Professional		$57.47	$70.98	$85.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $31.38 / $38.81	Professional	26	$24.70	$31.38	$38.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.75 / $40.47 / $48.19	Professional	TC	$31.75	$40.47	$48.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $42.56 / $48.00 / $84.96	Facility	26	$42.56	$48.00	$84.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $72.00 / $149.00	Professional		$37.00	$72.00	$149.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $88.46 / $179.02	Professional		$34.94	$88.46	$179.02
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $29.32 / $38.77 / $62.61	Professional	26	$29.32	$38.77	$62.61
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $33.01 / $55.79 / $120.45	Professional	TC	$33.01	$55.79	$120.45
United Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $78.59 / $126.62	Professional		$47.54	$78.59	$126.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.67 / $33.90 / $47.83	Professional	26	$21.67	$33.90	$47.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.00 / $44.19 / $80.58	Professional	TC	$24.00	$44.19	$80.58