Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.24 / $25.53 / $50.35	Professional		$22.24	$25.53	$50.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.13 / $19.48 / $38.39	Professional	26	$17.13	$19.48	$38.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.76 / $7.36 / $12.59	Professional	TC	$5.76	$7.36	$12.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.53 / $12.53 / $26.14	Professional		$12.53	$12.53	$26.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $9.36 / $19.53	Professional	26	$9.36	$9.36	$19.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.17 / $3.17 / $6.61	Professional	TC	$3.17	$3.17	$6.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $26.64 / $34.63	Professional		$26.42	$26.64	$34.63
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $19.46 / $26.02	Professional	26	$18.48	$19.46	$26.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $7.18 / $7.94 / $8.61	Professional	TC	$7.18	$7.94	$8.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.64 / $17.41 / $49.25	Professional		$13.64	$17.41	$49.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $12.88 / $37.57	Professional	26	$9.84	$12.88	$37.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.20 / $4.88 / $13.42	Professional	TC	$3.20	$4.88	$13.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $37.04 / $46.28	Professional		$28.50	$37.04	$46.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.22 / $26.29 / $34.08	Professional	26	$20.22	$26.29	$34.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $8.27 / $11.02 / $12.53	Professional	TC	$8.27	$11.02	$12.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $41.20 / $41.20 / $62.49	Facility	26	$41.20	$41.20	$62.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $9.00 / $30.73 / $56.00	Professional		$9.00	$30.73	$56.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $9.25 / $30.15 / $44.34	Professional		$9.25	$30.15	$44.34
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $21.15 / $23.56 / $38.65	Professional	26	$21.15	$23.56	$38.65
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $6.21 / $7.30 / $13.27	Professional	TC	$6.21	$7.30	$13.27
United Facility/Professional Professional Modifier Low / Median / High Price $18.09 / $30.15 / $56.58	Professional		$18.09	$30.15	$56.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $22.99 / $43.51	Professional	26	$13.79	$22.99	$43.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.30 / $7.16 / $13.24	Professional	TC	$4.30	$7.16	$13.24