Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.72 / $18.48 / $35.89	Professional		$13.72	$18.48	$35.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $12.87 / $34.07	Professional	26	$10.15	$12.87	$34.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.96 / $7.72 / $15.14	Professional	TC	$5.96	$7.72	$15.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.07 / $9.07 / $18.92	Professional		$9.07	$9.07	$18.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.33 / $5.33 / $11.20	Professional	26	$5.33	$5.33	$11.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.74 / $3.74 / $7.80	Professional	TC	$3.74	$3.74	$7.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $21.94 / $29.43	Professional		$21.94	$21.94	$29.43
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $13.91 / $13.91 / $18.66	Professional	26	$13.91	$13.91	$18.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $8.02 / $8.02 / $10.77	Professional	TC	$8.02	$8.02	$10.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.86 / $12.41 / $34.85	Professional		$8.86	$12.41	$34.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.48 / $7.27 / $23.76	Professional	26	$5.48	$7.27	$23.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.27 / $5.15 / $13.99	Professional	TC	$3.27	$5.15	$13.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.41 / $25.23 / $32.36	Professional		$19.41	$25.23	$32.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $14.98 / $19.54	Professional	26	$11.52	$14.98	$19.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $7.88 / $10.59 / $12.81	Professional	TC	$7.88	$10.59	$12.81
Medcost Facility/Professional Facility Modifier Low / Median / High Price $18.48 / $26.85 / $41.50	Facility		$18.48	$26.85	$41.50
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.00 / $23.14 / $39.00	Facility	26	$21.00	$23.14	$39.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $13.37 / $13.37 / $23.16	Facility	TC	$13.37	$13.37	$23.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $20.00 / $35.00	Professional		$11.00	$20.00	$35.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $18.30 / $32.11	Facility		$8.91	$18.30	$32.11
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.03 / $23.37 / $40.60	Professional		$10.03	$23.37	$40.60
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $17.73 / $27.21	Professional	26	$13.64	$17.73	$27.21
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $7.37 / $11.88 / $19.71	Professional	TC	$7.37	$11.88	$19.71
United Facility/Professional Professional Modifier Low / Median / High Price $12.68 / $21.83 / $35.22	Professional		$12.68	$21.83	$35.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $12.92 / $25.88	Professional	26	$7.75	$12.92	$25.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.91 / $7.32 / $14.43	Professional	TC	$3.91	$7.32	$14.43