Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.80 / $4.75 / $14.56	Facility	26	$2.80	$4.75	$14.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.98 / $29.65 / $53.08	Professional		$22.98	$29.65	$53.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.80 / $3.56 / $6.41	Professional	26	$2.80	$3.56	$6.41
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.03 / $11.94 / $14.83	Professional	52	$11.03	$11.94	$14.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.02 / $24.23 / $48.22	Professional	TC	$20.02	$24.23	$48.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.51 / $27.51 / $45.48	Professional		$21.51	$27.51	$45.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.76 / $3.54 / $5.30	Professional	26	$2.76	$3.54	$5.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $23.97 / $39.61	Professional	TC	$18.73	$23.97	$39.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $24.71 / $27.46 / $404.99	Professional		$24.71	$27.46	$404.99
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $3.26 / $3.58 / $6.77	Professional	26	$3.26	$3.58	$6.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.22 / $21.22 / $41.38	Professional	TC	$21.22	$21.22	$41.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.36 / $40.04 / $130.69	Professional		$24.36	$40.04	$130.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $4.51 / $7.96	Professional	26	$3.09	$4.51	$7.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $34.47 / $126.42	Professional	TC	$20.70	$34.47	$126.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.68 / $27.21 / $34.10	Professional		$21.68	$27.21	$34.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $2.69 / $3.41 / $4.30	Professional	26	$2.69	$3.41	$4.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $23.89 / $30.11	Professional	TC	$18.78	$23.89	$30.11
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $4.05 / $11.25 / $79.00	Facility	26	$4.05	$11.25	$79.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $31.00 / $75.00	Professional		$4.00	$31.00	$75.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $4.88 / $34.83 / $141.83	Professional		$4.88	$34.83	$141.83
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $3.53 / $4.73 / $7.15	Professional	26	$3.53	$4.73	$7.15
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $23.68 / $32.09 / $58.59	Professional	TC	$23.68	$32.09	$58.59
United Facility/Professional Professional Modifier Low / Median / High Price $21.61 / $40.72 / $146.05	Professional		$21.61	$40.72	$146.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.65 / $4.09 / $6.37	Professional	26	$2.65	$4.09	$6.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $33.79 / $137.96	Professional	TC	$18.32	$33.79	$137.96