Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.50 / $51.55 / $79.38	Professional		$40.50	$51.55	$79.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $20.30 / $26.90	Professional	26	$17.36	$20.30	$26.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.49 / $25.67 / $43.03	Professional	TC	$21.49	$25.67	$43.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $50.97 / $62.07	Professional		$37.39	$50.97	$62.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.37 / $21.77 / $26.85	Professional	26	$16.37	$21.77	$26.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.21 / $28.92 / $37.47	Professional	TC	$21.21	$28.92	$37.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.12 / $48.12 / $52.93	Professional		$48.12	$48.12	$52.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.76 / $20.76 / $22.84	Professional	26	$20.76	$20.76	$22.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.36 / $27.36 / $30.10	Professional	TC	$27.36	$27.36	$30.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $56.09 / $107.89	Professional		$38.29	$56.09	$107.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.36 / $24.14 / $48.46	Professional	26	$16.36	$24.14	$48.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.58 / $32.28 / $62.35	Professional	TC	$20.58	$32.28	$62.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.19 / $48.56 / $62.66	Professional		$40.19	$48.56	$62.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.61 / $20.25 / $26.12	Professional	26	$17.61	$20.25	$26.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.56 / $28.32 / $36.54	Professional	TC	$22.56	$28.32	$36.54
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.00 / $23.00 / $24.34	Facility	26	$23.00	$23.00	$24.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $43.00 / $83.00	Professional		$28.00	$43.00	$83.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $23.66 / $50.85 / $86.53	Professional		$23.66	$50.85	$86.53
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $24.58 / $38.92	Professional	26	$19.57	$24.58	$38.92
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $40.15 / $58.88	Professional	TC	$25.71	$40.15	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $30.81 / $45.82 / $83.70	Professional		$30.81	$45.82	$83.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $18.32 / $30.68	Professional	26	$14.24	$18.32	$30.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.95 / $26.12 / $47.59	Professional	TC	$16.95	$26.12	$47.59