Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.90 / $77.62	Professional		$20.89	$30.90	$77.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $16.22 / $38.90	Professional	26	$5.01	$16.22	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.44 / $48.98	Professional	TC	$15.85	$23.44	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.88 / $63.10	Professional		$30.20	$33.88	$63.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $7.76 / $14.45	Professional	26	$6.92	$7.76	$14.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $26.30 / $48.98	Professional	TC	$23.44	$26.30	$48.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $33.11 / $38.90	Professional		$6.92	$33.11	$38.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.17 / $6.61	Professional	26	$6.17	$6.17	$6.61
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.18 / $31.62	Professional	TC	$26.92	$28.18	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $23.44 / $66.07	Professional		$14.45	$23.44	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $4.17 / $12.88	Professional	26	$3.16	$4.17	$12.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $18.62 / $52.48	Professional	TC	$11.22	$18.62	$52.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $47.86	Professional		$32.36	$41.69	$47.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.94 / $9.12	Professional	26	$6.61	$7.94	$9.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $38.02	Professional	TC	$25.70	$33.11	$38.02
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $44.67 / $81.28	Facility		$28.18	$44.67	$81.28
Medcost Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Professional		$24.55	$24.55	$24.55
Sentara Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $43.65 / $69.18	Facility		$8.13	$43.65	$69.18
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $51.29 / $74.13	Professional		$10.00	$51.29	$74.13
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $15.49	Professional	26	$7.08	$10.00	$15.49
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $50.12 / $66.07	Professional	TC	$33.88	$50.12	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $33.11 / $66.07	Professional		$18.62	$33.11	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $7.08 / $14.45	Professional	26	$4.27	$7.08	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $28.18 / $51.29	Professional	TC	$14.45	$28.18	$51.29