Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.55 / $103.37	Professional		$41.69	$48.55	$103.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.71 / $31.96 / $89.64	Professional	26	$27.71	$31.96	$89.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $19.13 / $37.49	Professional	TC	$14.84	$19.13	$37.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $23.62 / $49.29	Professional		$23.62	$23.62	$49.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $15.26 / $31.84	Professional	26	$15.26	$15.26	$31.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.35 / $8.35 / $17.42	Professional	TC	$8.35	$8.35	$17.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $50.52 / $50.96 / $63.33	Professional		$50.52	$50.96	$63.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $29.89 / $31.44 / $39.36	Professional	26	$29.89	$31.44	$39.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.52 / $20.62 / $23.99	Professional	TC	$19.52	$20.62	$23.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $32.38 / $101.83	Professional		$24.88	$32.38	$101.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.90 / $20.99 / $61.08	Professional	26	$14.90	$20.99	$61.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.92 / $12.68 / $35.14	Professional	TC	$8.92	$12.68	$35.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.04 / $70.25 / $89.49	Professional		$54.04	$70.25	$89.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.04 / $55.28	Professional	26	$33.11	$43.04	$55.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.93 / $27.98 / $34.22	Professional	TC	$20.93	$27.98	$34.22
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $41.00 / $67.06 / $101.72	Facility	26	$41.00	$67.06	$101.72
Medcost Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $50.00 / $93.56	Professional		$25.00	$50.00	$93.56
Sentara Facility/Professional Professional Modifier Low / Median / High Price $27.12 / $55.61 / $83.34	Professional		$27.12	$55.61	$83.34
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $37.46 / $62.67	Professional	26	$28.91	$37.46	$62.67
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $17.76 / $20.86 / $35.79	Professional	TC	$17.76	$20.86	$35.79
United Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $56.67 / $97.41	Professional		$34.00	$56.67	$97.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.11 / $37.39 / $60.52	Professional	26	$22.11	$37.39	$60.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.57 / $19.48 / $35.92	Professional	TC	$11.57	$19.48	$35.92