Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.76 / $60.00 / $117.36	Professional		$48.76	$60.00	$117.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.59 / $24.98 / $47.55	Professional	26	$21.59	$24.98	$47.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.40 / $35.01 / $69.81	Professional	TC	$30.40	$35.01	$69.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.66 / $29.66 / $61.89	Professional		$29.66	$29.66	$61.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $11.95 / $24.93	Professional	26	$11.95	$11.95	$24.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.71 / $17.71 / $36.95	Professional	TC	$17.71	$17.71	$36.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.62 / $70.02 / $87.55	Professional		$64.62	$70.02	$87.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $24.22 / $33.32	Professional	26	$23.38	$24.22	$33.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.39 / $45.64 / $54.23	Professional	TC	$40.39	$45.64	$54.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.01 / $40.88 / $111.43	Professional		$32.01	$40.88	$111.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.47 / $15.49 / $47.43	Professional	26	$12.47	$15.49	$47.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.19 / $25.02 / $71.05	Professional	TC	$17.19	$25.02	$71.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.48 / $99.44 / $117.39	Professional		$76.48	$99.44	$117.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.03 / $33.84 / $44.64	Professional	26	$26.03	$33.84	$44.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.46 / $67.42 / $76.61	Professional	TC	$50.46	$67.42	$76.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $38.00 / $53.54 / $89.00	Facility	26	$38.00	$53.54	$89.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $61.00 / $117.36	Professional		$37.00	$61.00	$117.36
Sentara Facility/Professional Professional Modifier Low / Median / High Price $33.53 / $69.13 / $109.82	Professional		$33.53	$69.13	$109.82
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $26.79 / $30.25 / $49.14	Professional	26	$26.79	$30.25	$49.14
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $31.05 / $41.10 / $74.30	Professional	TC	$31.05	$41.10	$74.30
United Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $69.65 / $122.39	Professional		$38.35	$69.65	$122.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.47 / $29.12 / $56.36	Professional	26	$17.47	$29.12	$56.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.76 / $40.02 / $65.16	Professional	TC	$17.76	$40.02	$65.16