Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.36 / $14.88 / $103.74	Facility	26	$8.36	$14.88	$103.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.09 / $36.67 / $97.90	Professional		$32.09	$36.67	$97.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $9.30 / $19.92	Professional	26	$8.07	$9.30	$19.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.64 / $28.31 / $87.98	Professional	TC	$23.64	$28.31	$87.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.17 / $45.98 / $76.75	Professional		$35.17	$45.98	$76.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $11.00 / $16.79	Professional	26	$8.41	$11.00	$16.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.75 / $34.97 / $59.04	Professional	TC	$26.75	$34.97	$59.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $52.90 / $53.16 / $188.79	Professional		$52.90	$53.16	$188.79
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.79 / $10.79 / $16.72	Professional	26	$10.79	$10.79	$16.72
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $42.11 / $42.37 / $79.59	Professional	TC	$42.11	$42.37	$79.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $66.47 / $149.88	Professional		$33.29	$66.47	$149.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.55 / $20.70	Professional	26	$7.59	$12.55	$20.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.88 / $48.89 / $128.31	Professional	TC	$24.88	$48.89	$128.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.92 / $45.50 / $55.01	Professional		$37.92	$45.50	$55.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $10.41 / $12.54	Professional	26	$8.42	$10.41	$12.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $35.38 / $42.47	Professional	TC	$29.49	$35.38	$42.47
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.98 / $21.99 / $38.40	Facility	26	$10.98	$21.99	$38.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $50.00 / $99.00	Professional		$13.00	$50.00	$99.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.43 / $71.16 / $143.30	Professional		$13.43	$71.16	$143.30
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $13.36 / $21.16	Professional	26	$10.25	$13.36	$21.16
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $30.57 / $56.35 / $123.11	Professional	TC	$30.57	$56.35	$123.11
United Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $54.79 / $126.47	Professional		$33.40	$54.79	$126.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $11.83 / $19.60	Professional	26	$7.56	$11.83	$19.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.20 / $44.92 / $132.55	Professional	TC	$25.20	$44.92	$132.55