Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.64 / $20.91 / $63.44	Facility	26	$14.64	$20.91	$63.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $41.10 / $60.86	Professional		$31.68	$41.10	$60.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $14.72 / $21.90	Professional	26	$12.26	$14.72	$21.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $26.27 / $37.53	Professional	TC	$19.89	$26.27	$37.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.38 / $53.94 / $80.20	Professional		$42.38	$53.94	$80.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.73 / $18.82 / $26.74	Professional	26	$14.73	$18.82	$26.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.65 / $34.42 / $50.29	Professional	TC	$26.65	$34.42	$50.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $44.51 / $52.26 / $119.53	Professional		$44.51	$52.26	$119.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $17.01 / $18.32 / $23.27	Professional	26	$17.01	$18.32	$23.27
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.19 / $33.26 / $47.88	Professional	TC	$26.19	$33.26	$47.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $57.59 / $102.04	Professional		$36.11	$57.59	$102.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.85 / $20.01 / $33.72	Professional	26	$12.85	$20.01	$33.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.54 / $36.76 / $68.88	Professional	TC	$22.54	$36.76	$68.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $53.17 / $65.43	Professional		$44.31	$53.17	$65.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $18.30 / $22.08	Professional	26	$14.82	$18.30	$22.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $35.38 / $43.36	Professional	TC	$29.49	$35.38	$43.36
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $19.13 / $30.54 / $55.44	Facility	26	$19.13	$30.54	$55.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $39.00 / $72.14	Professional		$21.00	$39.00	$72.14
Sentara Facility/Professional Professional Modifier Low / Median / High Price $20.01 / $49.90 / $90.56	Professional		$20.01	$49.90	$90.56
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $15.82 / $22.31 / $35.76	Professional	26	$15.82	$22.31	$35.76
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $28.73 / $39.76 / $64.80	Professional	TC	$28.73	$39.76	$64.80
United Facility/Professional Professional Modifier Low / Median / High Price $36.92 / $54.48 / $86.73	Professional		$36.92	$54.48	$86.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $20.69 / $33.20	Professional	26	$12.91	$20.69	$33.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.86 / $34.29 / $57.62	Professional	TC	$22.86	$34.29	$57.62