Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.90 / $38.44 / $91.43	Facility	26	$20.90	$38.44	$91.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $42.79 / $86.55	Professional		$39.72	$42.79	$86.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.74 / $23.21 / $46.86	Professional	26	$20.74	$23.21	$46.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $21.07 / $41.29	Professional	TC	$18.48	$21.07	$41.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $51.18 / $72.68	Professional		$41.18	$51.18	$72.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.45 / $26.86 / $37.88	Professional	26	$21.45	$26.86	$37.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.42 / $24.50 / $34.71	Professional	TC	$19.42	$24.50	$34.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.74 / $50.82 / $307.58	Professional		$45.74	$50.82	$307.58
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.21 / $27.21 / $51.43	Professional	26	$27.21	$27.21	$51.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.45 / $20.54 / $40.04	Professional	TC	$20.45	$20.54	$40.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.06 / $64.45 / $121.43	Professional		$37.06	$64.45	$121.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $31.25 / $56.37	Professional	26	$19.12	$31.25	$56.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.78 / $30.57 / $70.75	Professional	TC	$16.78	$30.57	$70.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $51.14 / $62.95	Professional		$41.40	$51.14	$62.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $26.78 / $33.29	Professional	26	$21.08	$26.78	$33.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.66 / $25.10 / $31.60	Professional	TC	$19.66	$25.10	$31.60
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $34.97 / $40.90 / $73.66	Facility	26	$34.97	$40.90	$73.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $43.00 / $86.00	Professional		$28.00	$43.00	$86.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $25.96 / $55.37 / $107.95	Professional		$25.96	$55.37	$107.95
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $34.11 / $53.65	Professional	26	$25.98	$34.11	$53.65
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.93 / $32.21 / $50.61	Professional	TC	$21.93	$32.21	$50.61
United Facility/Professional Professional Modifier Low / Median / High Price $37.35 / $58.43 / $111.38	Professional		$37.35	$58.43	$111.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.34 / $26.87 / $42.02	Professional	26	$18.34	$26.87	$42.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.43 / $28.51 / $73.34	Professional	TC	$17.43	$28.51	$73.34