Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $35.63 / $70.87	Professional		$27.44	$35.63	$70.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $11.76 / $32.07	Professional	26	$8.57	$11.76	$32.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.52 / $29.01 / $55.45	Professional	TC	$22.52	$29.01	$55.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.20 / $40.20 / $83.88	Professional		$40.20	$40.20	$83.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $10.83 / $22.60	Professional	26	$10.83	$10.83	$22.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.34 / $28.34 / $59.13	Professional	TC	$28.34	$28.34	$59.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $41.32 / $41.32 / $51.04	Professional		$41.32	$41.32	$51.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $12.75 / $17.14	Professional	26	$12.75	$12.75	$17.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.57 / $28.57 / $33.90	Professional	TC	$28.57	$28.57	$33.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.54 / $28.95 / $81.70	Professional		$19.54	$28.95	$81.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.17 / $6.53 / $22.18	Professional	26	$5.17	$6.53	$22.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.04 / $22.85 / $62.96	Professional	TC	$14.04	$22.85	$62.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $53.22 / $91.92	Professional		$40.72	$53.22	$91.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.56 / $13.73 / $17.86	Professional	26	$10.56	$13.73	$17.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.16 / $40.28 / $69.58	Professional	TC	$30.16	$40.28	$69.58
Medcost Facility/Professional Facility Modifier Low / Median / High Price $38.31 / $62.50 / $113.31	Facility		$38.31	$62.50	$113.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.22 / $36.00 / $55.00	Facility	26	$21.22	$36.00	$55.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $77.28 / $77.28 / $111.60	Facility	TC	$77.28	$77.28	$111.60
Medcost Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $44.70 / $88.00	Professional		$15.00	$44.70	$88.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $13.72 / $51.96 / $80.05	Facility		$13.72	$51.96	$80.05
Sentara Facility/Professional Professional Modifier Low / Median / High Price $16.02 / $62.37 / $92.66	Professional		$16.02	$62.37	$92.66
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $16.64 / $24.94	Professional	26	$11.48	$16.64	$24.94
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $41.78 / $55.05 / $74.39	Professional	TC	$41.78	$55.05	$74.39
United Facility/Professional Professional Modifier Low / Median / High Price $24.90 / $43.39 / $83.72	Professional		$24.90	$43.39	$83.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.10 / $11.84 / $21.95	Professional	26	$7.10	$11.84	$21.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.80 / $32.95 / $65.56	Professional	TC	$17.80	$32.95	$65.56