Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $14.13 / $44.67	Professional		$10.00	$14.13	$44.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $8.32 / $20.89	Professional	26	$3.02	$8.32	$20.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.92 / $10.00 / $22.91	Professional	TC	$6.92	$10.00	$22.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $15.85 / $29.51	Professional		$14.13	$15.85	$29.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $4.79 / $8.91	Professional	26	$4.27	$4.79	$8.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $11.22 / $20.42	Professional	TC	$9.77	$11.22	$20.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $4.07 / $14.45 / $19.05	Professional		$4.07	$14.45	$19.05
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $4.27 / $4.68	Professional	26	$4.27	$4.27	$4.68
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $13.18 / $13.18	Professional	TC	$13.18	$13.18	$13.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $11.22 / $32.36	Professional		$7.08	$11.22	$32.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.04 / $2.69 / $8.32	Professional	26	$2.04	$2.69	$8.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.13 / $8.13 / $23.44	Professional	TC	$5.13	$8.13	$23.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $20.89 / $23.44	Professional		$15.85	$20.89	$23.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $5.25 / $5.89	Professional	26	$4.27	$5.25	$5.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $15.14 / $17.78	Professional	TC	$11.75	$15.14	$17.78
Medcost Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $22.39 / $38.90	Facility		$14.13	$22.39	$38.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $8.91 / $8.91	Professional		$8.91	$8.91	$8.91
Sentara Facility/Professional Facility Modifier Low / Median / High Price $5.37 / $15.85 / $33.88	Facility		$5.37	$15.85	$33.88
Sentara Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $22.39 / $36.31	Professional		$6.17	$22.39	$36.31
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $4.57 / $6.46 / $9.77	Professional	26	$4.57	$6.46	$9.77
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $20.42 / $32.36	Professional	TC	$10.72	$20.42	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $15.85 / $36.31	Professional		$9.33	$15.85	$36.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.75 / $4.68 / $9.33	Professional	26	$2.75	$4.68	$9.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $12.02 / $23.99	Professional	TC	$6.76	$12.02	$23.99