Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.28 / $47.93 / $91.29	Professional		$41.28	$47.93	$91.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.90 / $27.41 / $3,650.85	Professional	26	$23.90	$27.41	$3,650.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $18.98 / $38.82	Professional	TC	$17.72	$18.98	$38.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $21.74 / $45.36	Professional		$21.74	$21.74	$45.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $13.10 / $30.36	Professional	26	$13.10	$13.10	$30.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.64 / $8.64 / $18.02	Professional	TC	$8.64	$8.64	$18.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $56.73 / $70.66	Professional		$56.73	$56.73	$70.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $33.94 / $45.85	Professional	26	$33.94	$33.94	$45.85
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.79 / $22.79 / $26.66	Professional	TC	$22.79	$22.79	$26.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $31.95 / $90.20	Professional		$20.89	$31.95	$90.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.73 / $17.80 / $54.00	Professional	26	$13.73	$17.80	$54.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.63 / $12.39 / $41.07	Professional	TC	$5.63	$12.39	$41.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.39 / $68.11 / $75.80	Professional		$52.39	$68.11	$75.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $37.18 / $48.08	Professional	26	$28.60	$37.18	$48.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.80 / $30.94 / $36.14	Professional	TC	$23.80	$30.94	$36.14
Medcost Facility/Professional Facility Modifier Low / Median / High Price $48.56 / $64.03 / $97.86	Facility		$48.56	$64.03	$97.86
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $57.37 / $93.00	Facility	26	$50.00	$57.37	$93.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $23.00 / $47.00 / $83.00	Professional		$23.00	$47.00	$83.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $14.24 / $45.68 / $83.30	Facility		$14.24	$45.68	$83.30
Sentara Facility/Professional Professional Modifier Low / Median / High Price $16.63 / $52.78 / $103.01	Professional		$16.63	$52.78	$103.01
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $44.38 / $67.38	Professional	26	$34.22	$44.38	$67.38
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $13.10 / $32.76 / $53.12	Professional	TC	$13.10	$32.76	$53.12
United Facility/Professional Professional Modifier Low / Median / High Price $27.98 / $52.81 / $83.37	Professional		$27.98	$52.81	$83.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $32.35 / $63.40	Professional	26	$19.41	$32.35	$63.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.39 / $15.55 / $34.65	Professional	TC	$6.39	$15.55	$34.65