Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.12 / $44.67	Professional		$20.89	$25.12	$44.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.95 / $25.70	Professional	26	$18.20	$19.95	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $22.91	Professional	TC	$3.02	$3.98	$22.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.18 / $52.48	Professional		$21.88	$28.18	$52.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.39 / $43.65	Professional	26	$18.62	$22.39	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.47 / $4.68 / $9.33	Professional	TC	$3.47	$4.68	$9.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $25.70 / $30.90	Professional		$23.44	$25.70	$30.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $20.89 / $25.70	Professional	26	$20.89	$20.89	$25.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $4.68 / $5.25 / $5.75	Professional	TC	$4.68	$5.25	$5.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $21.38 / $21.38	Facility	26	$21.38	$21.38	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $31.62 / $66.07	Professional		$21.38	$31.62	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.99 / $42.66	Professional	26	$17.78	$23.99	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.39 / $5.75 / $38.02	Professional	TC	$3.39	$5.75	$38.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.70 / $33.11	Professional		$19.50	$25.70	$33.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $20.89 / $26.92	Professional	26	$16.22	$20.89	$26.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.31 / $4.68 / $6.03	Professional	TC	$3.31	$4.68	$6.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $74.13	Professional		$46.77	$58.88	$74.13
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.11 / $38.02	Professional	26	$26.92	$33.11	$38.02
Medcost Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $28.18 / $58.88	Professional		$10.72	$28.18	$58.88
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $22.39 / $33.11	Professional	26	$17.78	$22.39	$33.11
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $6.92 / $38.02	Professional	TC	$4.07	$6.92	$38.02
United Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $28.18 / $57.54	Professional		$16.98	$28.18	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $17.78 / $29.51	Professional	26	$14.13	$17.78	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $4.68 / $34.67	Professional	TC	$2.88	$4.68	$34.67