Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.09 / $29.27 / $41.94	Professional		$25.09	$29.27	$41.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $24.15 / $32.32	Professional	26	$17.73	$24.15	$32.32
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.55 / $14.49 / $20.05	Professional	52	$12.55	$14.49	$20.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.29 / $4.15 / $26.59	Professional	TC	$3.29	$4.15	$26.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.08 / $31.09 / $44.83	Professional		$25.08	$31.09	$44.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.43 / $25.82 / $32.13	Professional	26	$20.43	$25.82	$32.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.22 / $4.63 / $8.88	Professional	TC	$3.22	$4.63	$8.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $33.29 / $39.15	Professional		$33.29	$33.29	$39.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $28.14 / $34.25	Professional	26	$28.14	$28.14	$34.25
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $4.46 / $5.15 / $5.15	Professional	TC	$4.46	$5.15	$5.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.60 / $27.95 / $27.95	Facility	26	$17.60	$27.95	$27.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.65 / $34.13 / $74.04	Professional		$24.65	$34.13	$74.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $25.27 / $57.21	Professional	26	$18.89	$25.27	$57.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.26 / $5.74 / $44.07	Professional	TC	$3.26	$5.74	$44.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $28.88 / $37.26	Professional		$24.75	$28.88	$37.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $24.58 / $31.72	Professional	26	$21.38	$24.58	$31.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.38 / $4.30 / $5.50	Professional	TC	$3.38	$4.30	$5.50
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $23.00 / $23.52	Facility	26	$17.75	$23.00	$23.52
Medcost Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $34.00 / $67.92	Professional		$3.00	$34.00	$67.92
Sentara Facility/Professional Professional Modifier Low / Median / High Price $12.48 / $30.14 / $62.68	Professional		$12.48	$30.14	$62.68
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $24.60 / $47.36	Professional	26	$16.80	$24.60	$47.36
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $3.75 / $7.28 / $44.84	Professional	TC	$3.75	$7.28	$44.84
United Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $30.96 / $59.10	Professional		$19.57	$30.96	$59.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.68 / $19.92 / $37.11	Professional	26	$13.68	$19.92	$37.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.76 / $4.34 / $37.70	Professional	TC	$2.76	$4.34	$37.70