Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.52 / $16.94 / $69.28	Facility	26	$13.52	$16.94	$69.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.85 / $43.30 / $60.52	Professional		$23.85	$43.30	$60.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.37 / $22.27	Professional	26	$12.88	$15.37	$22.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.97 / $28.87 / $39.40	Professional	TC	$10.97	$28.87	$39.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.59 / $53.06 / $79.59	Professional		$40.59	$53.06	$79.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.21 / $16.89 / $25.35	Professional	26	$13.21	$16.89	$25.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.66 / $36.15 / $54.24	Professional	TC	$27.66	$36.15	$54.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.33 / $48.33 / $91.34	Professional		$48.33	$48.33	$91.34
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $14.77 / $27.92	Professional	26	$14.77	$14.77	$27.92
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $33.54 / $33.54 / $63.41	Professional	TC	$33.54	$33.54	$63.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.94 / $45.75 / $100.25	Professional		$29.94	$45.75	$100.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $19.46 / $38.08	Professional	26	$14.19	$19.46	$38.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.24 / $28.56 / $62.77	Professional	TC	$13.24	$28.56	$62.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $49.96 / $72.62	Professional		$39.97	$49.96	$72.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.21 / $15.26 / $26.33	Professional	26	$12.21	$15.26	$26.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.86 / $34.69 / $46.83	Professional	TC	$22.86	$34.69	$46.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.50 / $17.53 / $39.42	Facility	26	$15.50	$17.53	$39.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $26.00 / $61.00	Professional		$16.00	$26.00	$61.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.85 / $31.20 / $74.64	Professional		$13.85	$31.20	$74.64
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $14.48 / $18.05 / $31.75	Professional	26	$14.48	$18.05	$31.75
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $12.09 / $25.56 / $58.10	Professional	TC	$12.09	$25.56	$58.10
United Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $40.18 / $74.64	Professional		$25.30	$40.18	$74.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.15 / $17.57 / $29.09	Professional	26	$12.15	$17.57	$29.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.84 / $24.51 / $47.90	Professional	TC	$11.84	$24.51	$47.90