Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $66.42 / $90.53	Professional		$53.00	$66.42	$90.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $36.04 / $52.87	Professional	26	$30.92	$36.04	$52.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $25.80 / $36.69	Professional	TC	$21.76	$25.80	$36.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.65 / $67.51 / $84.08	Professional		$50.65	$67.51	$84.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $38.54 / $47.98	Professional	26	$28.91	$38.54	$47.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $29.27 / $36.10	Professional	TC	$19.80	$29.27	$36.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $59.52 / $65.47	Professional		$59.52	$59.52	$65.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $33.15 / $36.47	Professional	26	$33.15	$33.15	$36.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.37 / $26.37 / $29.01	Professional	TC	$26.37	$26.37	$29.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.59 / $41.59 / $41.59	Facility	26	$41.59	$41.59	$41.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.91 / $69.04 / $141.91	Professional		$50.91	$69.04	$141.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.86 / $40.82 / $85.04	Professional	26	$28.86	$40.82	$85.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.87 / $26.94 / $59.32	Professional	TC	$19.87	$26.94	$59.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $65.68 / $84.74	Professional		$54.95	$65.68	$84.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.52 / $36.28 / $46.81	Professional	26	$31.52	$36.28	$46.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.43 / $29.40 / $37.93	Professional	TC	$23.43	$29.40	$37.93
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $36.00 / $36.00 / $37.77	Facility	26	$36.00	$36.00	$37.77
Medcost Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $55.00 / $94.77	Professional		$33.00	$55.00	$94.77
Sentara Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $59.65 / $91.59	Professional		$25.75	$59.65	$91.59
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $32.50 / $41.54 / $69.45	Professional	26	$32.50	$41.54	$69.45
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $27.69 / $47.81	Professional	TC	$20.41	$27.69	$47.81
United Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $51.34 / $84.98	Professional		$39.65	$51.34	$84.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.62 / $30.90 / $54.04	Professional	26	$24.62	$30.90	$54.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.83 / $20.57 / $35.14	Professional	TC	$14.83	$20.57	$35.14