Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $7.11 / $29.08	Facility	26	$5.45	$7.11	$29.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $6.75 / $22.98	Professional	26	$5.45	$6.75	$22.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.18 / $22.39 / $36.92	Professional	TC	$18.18	$22.39	$36.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $13.88 / $58.79	Professional	26	$10.48	$13.88	$58.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.35 / $17.66 / $195.23	Professional	TC	$13.35	$17.66	$195.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $35.19	Professional	26	$18.62	$18.62	$35.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $64.44 / $121.79	Professional	TC	$64.44	$64.44	$121.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $32.49 / $63.18	Professional	26	$23.97	$32.49	$63.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.94 / $106.24 / $203.93	Professional	TC	$76.94	$106.24	$203.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $25.86 / $34.90	Professional	26	$20.69	$25.86	$34.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.62 / $87.29 / $107.66	Professional	TC	$70.62	$87.29	$107.66
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.08 / $27.15 / $43.68	Facility	26	$23.08	$27.15	$43.68
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $23.65 / $28.38 / $48.27	Professional	26	$23.65	$28.38	$48.27
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $74.61 / $91.35 / $157.43	Professional	TC	$74.61	$91.35	$157.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $27.51 / $32.61	Professional	26	$19.39	$27.51	$32.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.20 / $90.93 / $113.60	Professional	TC	$66.20	$90.93	$113.60