Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.76 / $29.72 / $58.39	Professional		$23.76	$29.72	$58.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.65 / $10.11 / $20.22	Professional	26	$5.65	$10.11	$20.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $24.07 / $50.34	Professional	TC	$18.68	$24.07	$50.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $30.18 / $62.97	Professional		$30.18	$30.18	$62.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $6.89 / $14.37	Professional	26	$6.89	$6.89	$14.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $23.29 / $48.60	Professional	TC	$23.29	$23.29	$48.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $31.19 / $38.34	Professional		$31.19	$31.19	$38.34
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $7.76 / $10.64	Professional	26	$7.76	$7.76	$10.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.43 / $23.43 / $27.70	Professional	TC	$23.43	$23.43	$27.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.61 / $22.74 / $65.62	Professional		$14.61	$22.74	$65.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.14 / $4.04 / $12.87	Professional	26	$3.14	$4.04	$12.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.20 / $18.27 / $52.22	Professional	TC	$11.20	$18.27	$52.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $41.77 / $72.14	Professional		$31.76	$41.77	$72.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $8.27 / $10.60	Professional	26	$6.37	$8.27	$10.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $33.92 / $58.60	Professional	TC	$25.39	$33.92	$58.60
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.72 / $48.11 / $80.98	Facility		$29.72	$48.11	$80.98
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.00 / $12.80 / $22.00	Facility	26	$12.00	$12.80	$22.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $9.00 / $34.45 / $69.00	Professional		$9.00	$34.45	$69.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $8.16 / $43.55 / $66.62	Facility		$8.16	$43.55	$66.62
Sentara Facility/Professional Professional Modifier Low / Median / High Price $9.96 / $50.97 / $72.78	Professional		$9.96	$50.97	$72.78
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $7.04 / $10.05 / $15.29	Professional	26	$7.04	$10.05	$15.29
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $34.19 / $47.21 / $62.74	Professional	TC	$34.19	$47.21	$62.74
United Facility/Professional Professional Modifier Low / Median / High Price $18.64 / $33.01 / $63.66	Professional		$18.64	$33.01	$63.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.23 / $7.04 / $14.44	Professional	26	$4.23	$7.04	$14.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.35 / $27.99 / $51.87	Professional	TC	$14.35	$27.99	$51.87