Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.62 / $48.03 / $87.91	Facility	26	$29.62	$48.03	$87.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.95 / $62.41 / $123.22	Professional		$59.95	$62.41	$123.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $41.02 / $212.49	Professional	26	$28.41	$41.02	$212.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.34 / $35.34 / $61.51	Professional	TC	$30.34	$35.34	$61.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.84 / $77.56 / $116.82	Professional		$60.84	$77.56	$116.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.80 / $37.99 / $57.23	Professional	26	$29.80	$37.99	$57.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.03 / $39.56 / $58.83	Professional	TC	$31.03	$39.56	$58.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $74.65 / $91.15 / $314.73	Professional		$74.65	$91.15	$314.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.08 / $33.08 / $33.28	Professional	26	$33.08	$33.08	$33.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $41.57 / $41.57 / $57.87	Professional	TC	$41.57	$41.57	$57.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $93.32 / $172.18	Professional		$57.11	$93.32	$172.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.35 / $43.04 / $81.98	Professional	26	$28.35	$43.04	$81.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.01 / $52.90 / $89.48	Professional	TC	$30.01	$52.90	$89.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $89.43 / $93.94	Professional		$66.25	$89.43	$93.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $42.53 / $46.84	Professional	26	$32.40	$42.53	$46.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.84 / $47.25 / $48.41	Professional	TC	$33.84	$47.25	$48.41
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $44.48 / $60.00 / $96.35	Facility	26	$44.48	$60.00	$96.35
Medcost Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $60.00 / $113.00	Professional		$41.00	$60.00	$113.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $35.82 / $80.55 / $1,919.00	Professional		$35.82	$80.55	$1,919.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $46.56 / $71.06	Professional	26	$32.86	$46.56	$71.06
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $37.39 / $50.05 / $78.87	Professional	TC	$37.39	$50.05	$78.87
United Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $87.54 / $138.90	Professional		$53.87	$87.54	$138.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.67 / $40.08 / $60.49	Professional	26	$26.67	$40.08	$60.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.23 / $44.58 / $72.31	Professional	TC	$29.23	$44.58	$72.31