Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.59 / $11.73 / $33.78	Facility	26	$6.59	$11.73	$33.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $29.92 / $51.42	Professional		$24.70	$29.92	$51.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.59 / $8.26 / $14.96	Professional	26	$6.59	$8.26	$14.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.80 / $21.50 / $38.65	Professional	TC	$17.80	$21.50	$38.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.40 / $29.48 / $44.22	Professional		$23.40	$29.48	$44.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $8.25 / $12.37	Professional	26	$6.55	$8.25	$12.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $21.22 / $32.10	Professional	TC	$16.64	$21.22	$32.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $29.08 / $175.50	Professional		$27.74	$29.08	$175.50
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $7.78 / $14.70	Professional	26	$7.65	$7.78	$14.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.96 / $19.96 / $38.92	Professional	TC	$19.96	$19.96	$38.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $8.11 / $8.11	Facility	26	$8.11	$8.11	$8.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $39.89 / $70.00	Professional		$26.17	$39.89	$70.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.13 / $10.10 / $18.48	Professional	26	$7.13	$10.10	$18.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $29.17 / $54.07	Professional	TC	$19.14	$29.17	$54.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.57 / $29.26 / $36.07	Professional		$23.57	$29.26	$36.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $8.02 / $9.92	Professional	26	$6.32	$8.02	$9.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $16.87 / $21.46 / $26.66	Professional	TC	$16.87	$21.46	$26.66
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $8.61 / $13.00 / $23.26	Facility	26	$8.61	$13.00	$23.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $9.00 / $29.00 / $54.00	Professional		$9.00	$29.00	$54.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.17 / $35.57 / $63.83	Professional		$10.17	$35.57	$63.83
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $10.44 / $15.99	Professional	26	$7.90	$10.44	$15.99
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $21.93 / $28.47 / $46.01	Professional	TC	$21.93	$28.47	$46.01
United Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $36.40 / $64.87	Professional		$21.70	$36.40	$64.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.02 / $9.15 / $14.66	Professional	26	$6.02	$9.15	$14.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.66 / $26.99 / $55.39	Professional	TC	$16.66	$26.99	$55.39