Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $15.04 / $23.69	Facility	26	$9.77	$15.04	$23.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $36.76 / $62.64	Professional		$28.57	$36.76	$62.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.76 / $23.46	Professional	26	$9.77	$13.76	$23.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.54 / $22.43 / $39.76	Professional	TC	$18.54	$22.43	$39.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $36.15 / $59.78	Professional		$28.71	$36.15	$59.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $12.55 / $20.13	Professional	26	$9.67	$12.55	$20.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $23.97 / $39.61	Professional	TC	$18.68	$23.97	$39.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $33.10 / $41.38	Professional		$30.78	$33.10	$41.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.35 / $12.56 / $17.57	Professional	26	$11.35	$12.56	$17.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $16.27 / $20.54 / $25.67	Professional	TC	$16.27	$20.54	$25.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $44.00 / $73.00	Professional		$31.11	$44.00	$73.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $16.63 / $30.20	Professional	26	$10.36	$16.63	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.63 / $27.78 / $47.60	Professional	TC	$19.63	$27.78	$47.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.03 / $34.83 / $42.83	Professional		$29.03	$34.83	$42.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $11.58 / $13.96	Professional	26	$9.38	$11.58	$13.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.66 / $23.59 / $28.91	Professional	TC	$19.66	$23.59	$28.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $17.09 / $17.20 / $37.13	Facility	26	$17.09	$17.20	$37.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $32.00 / $55.94	Professional		$17.00	$32.00	$55.94
Sentara Facility/Professional Professional Modifier Low / Median / High Price $18.25 / $41.06 / $70.65	Professional		$18.25	$41.06	$70.65
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $11.58 / $18.70 / $26.71	Professional	26	$11.58	$18.70	$26.71
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $22.09 / $30.09 / $46.76	Professional	TC	$22.09	$30.09	$46.76
United Facility/Professional Professional Modifier Low / Median / High Price $30.06 / $45.10 / $76.97	Professional		$30.06	$45.10	$76.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $17.70 / $27.96	Professional	26	$11.49	$17.70	$27.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $28.30 / $49.27	Professional	TC	$18.39	$28.30	$49.27