Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.02 / $33.46 / $98.24	Facility	26	$24.02	$33.46	$98.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $54.37 / $77.41	Professional		$38.25	$54.37	$77.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $23.48 / $36.84	Professional	26	$18.64	$23.48	$36.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.01 / $32.72 / $45.50	Professional	TC	$17.01	$32.72	$45.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $66.02 / $99.04	Professional		$50.50	$66.02	$99.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.43 / $23.58 / $35.36	Professional	26	$18.43	$23.58	$35.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.46 / $42.44 / $63.67	Professional	TC	$32.46	$42.44	$63.67
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.45 / $59.45 / $128.54	Professional		$59.45	$59.45	$128.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $21.11 / $21.11 / $39.90	Professional	26	$21.11	$21.11	$39.90
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.34 / $38.34 / $72.45	Professional	TC	$38.34	$38.34	$72.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $58.85 / $125.00	Professional		$43.99	$58.85	$125.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $28.17 / $51.98	Professional	26	$19.82	$28.17	$51.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.35 / $32.83 / $72.95	Professional	TC	$19.35	$32.83	$72.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $62.11 / $87.93	Professional		$49.69	$62.11	$87.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.00 / $21.25 / $35.69	Professional	26	$17.00	$21.25	$35.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.27 / $40.86 / $55.16	Professional	TC	$27.27	$40.86	$55.16
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $24.37 / $28.09 / $53.96	Facility	26	$24.37	$28.09	$53.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $37.00 / $76.00	Professional		$22.00	$37.00	$76.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $20.59 / $43.00 / $92.44	Professional		$20.59	$43.00	$92.44
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $20.77 / $27.09 / $43.32	Professional	26	$20.77	$27.09	$43.32
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $32.56 / $65.58	Professional	TC	$16.22	$32.56	$65.58
United Facility/Professional Professional Modifier Low / Median / High Price $35.81 / $54.57 / $94.43	Professional		$35.81	$54.57	$94.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $25.25 / $41.35	Professional	26	$17.32	$25.25	$41.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $28.51 / $54.06	Professional	TC	$17.23	$28.51	$54.06