Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.24 / $15.46 / $33.49	Facility	26	$9.24	$15.46	$33.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.92 / $29.77 / $50.55	Professional		$21.92	$29.77	$50.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $8.91 / $16.32	Professional	26	$8.14	$8.91	$16.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.50 / $20.53 / $34.53	Professional	TC	$14.50	$20.53	$34.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $36.45 / $54.61	Professional		$28.56	$36.45	$54.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $11.00 / $16.21	Professional	26	$8.63	$11.00	$16.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.60 / $25.59 / $36.65	Professional	TC	$18.60	$25.59	$36.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $35.94 / $84.48	Professional		$29.89	$35.94	$84.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.91 / $15.13	Professional	26	$11.22	$11.91	$15.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $22.83 / $32.84	Professional	TC	$17.98	$22.83	$32.84
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 $25.33 / $41.69 / $72.97	Professional		$25.33	$41.69	$72.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $12.75 / $21.31	Professional	26	$7.65	$12.75	$21.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $27.54 / $53.37	Professional	TC	$16.39	$27.54	$53.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.71 / $36.85 / $45.13	Professional		$30.71	$36.85	$45.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $10.41 / $12.88	Professional	26	$8.42	$10.41	$12.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $26.73 / $32.10	Professional	TC	$22.28	$26.73	$32.10
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.36 / $17.67 / $31.50	Facility	26	$11.36	$17.67	$31.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $27.00 / $50.00	Professional		$14.00	$27.00	$50.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $38.65 / $69.40	Professional		$14.53	$38.65	$69.40
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $14.95 / $24.19	Professional	26	$10.55	$14.95	$24.19
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.67 / $32.56 / $47.50	Professional	TC	$21.67	$32.56	$47.50
United Facility/Professional Professional Modifier Low / Median / High Price $26.04 / $39.06 / $65.37	Professional		$26.04	$39.06	$65.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.84 / $12.48 / $20.97	Professional	26	$7.84	$12.48	$20.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $26.58 / $44.66	Professional	TC	$17.72	$26.58	$44.66