Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $47.86 / $91.20	Professional		$38.02	$47.86	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $93.33	Professional	26	$26.92	$33.88	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $16.98 / $29.51	Professional	TC	$12.88	$16.98	$29.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $52.48	Professional		$23.99	$23.99	$52.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $34.67	Professional	26	$16.22	$16.22	$34.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $9.33 / $20.42	Professional	TC	$9.33	$9.33	$20.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $52.48 / $61.66	Professional		$19.50	$52.48	$61.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $35.48 / $39.81	Professional	26	$33.88	$35.48	$39.81
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.38 / $21.38	Professional	TC	$21.38	$21.38	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $35.48 / $95.50	Professional		$25.70	$35.48	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.39 / $64.57	Professional	26	$16.60	$22.39	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.32 / $12.59 / $32.36	Professional	TC	$8.32	$12.59	$32.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $66.07 / $75.86	Professional		$53.70	$66.07	$75.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $42.66 / $48.98	Professional	26	$34.67	$42.66	$48.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.99 / $27.54	Professional	TC	$18.20	$23.99	$27.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Sentara Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $70.79 / $107.15	Professional		$28.18	$70.79	$107.15
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $50.12 / $83.18	Professional	26	$36.31	$50.12	$83.18
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $28.18 / $41.69	Professional	TC	$14.45	$28.18	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $112.20	Professional		$31.62	$57.54	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $39.81 / $79.43	Professional	26	$21.88	$39.81	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $18.20 / $36.31	Professional	TC	$10.00	$18.20	$36.31