Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.53 / $10.45 / $15.51	Facility	26	$7.53	$10.45	$15.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $36.29 / $59.16	Professional		$25.45	$36.29	$59.16
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	25	$37.15	$37.15	$37.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $8.75 / $15.43	Professional	26	$7.37	$8.75	$15.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.63 / $24.95 / $40.97	Professional	TC	$17.63	$24.95	$40.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $32.22 / $44.98	Professional		$25.20	$32.22	$44.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $9.43 / $14.14	Professional	26	$7.37	$9.43	$14.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $22.79 / $32.57	Professional	TC	$17.82	$22.79	$32.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.78 / $31.78 / $65.15	Professional		$31.78	$31.78	$65.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $8.23 / $15.19	Professional	26	$8.23	$8.23	$15.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.55 / $23.55 / $43.46	Professional	TC	$23.55	$23.55	$43.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.49 / $42.18 / $66.22	Professional		$29.49	$42.18	$66.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $10.58 / $17.42	Professional	26	$8.02	$10.58	$17.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $31.19 / $50.14	Professional	TC	$20.71	$31.19	$50.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $31.26 / $46.29	Professional		$24.69	$31.26	$46.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $8.93 / $12.75	Professional	26	$6.80	$8.93	$12.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.36 / $33.54	Professional	TC	$17.89	$22.36	$33.54
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $8.65 / $11.00 / $19.00	Facility	26	$8.65	$11.00	$19.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $35.00 / $54.00	Professional		$11.00	$35.00	$54.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $10.37 / $36.94 / $66.48	Professional		$10.37	$36.94	$66.48
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $10.68 / $18.12	Professional	26	$8.27	$10.68	$18.12
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $19.42 / $30.72 / $50.47	Professional	TC	$19.42	$30.72	$50.47
United Facility/Professional Professional Modifier Low / Median / High Price $27.11 / $40.90 / $70.14	Professional		$27.11	$40.90	$70.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $9.47 / $14.81	Professional	26	$6.44	$9.47	$14.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.36 / $29.87 / $47.69	Professional	TC	$20.36	$29.87	$47.69