Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.38 / $15.94 / $25.80	Facility	26	$9.38	$15.94	$25.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.21 / $60.75 / $97.92	Professional		$36.21	$60.75	$97.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $13.69 / $23.69	Professional	26	$9.38	$13.69	$23.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.42 / $44.79 / $74.39	Professional	TC	$26.42	$44.79	$74.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $45.98 / $69.65	Professional		$36.50	$45.98	$69.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $11.79 / $17.69	Professional	26	$9.36	$11.79	$17.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.14 / $34.19 / $51.29	Professional	TC	$27.14	$34.19	$51.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $47.85 / $47.85 / $98.09	Professional		$47.85	$47.85	$98.09
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.47 / $11.47 / $21.16	Professional	26	$11.47	$11.47	$21.16
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $36.38 / $36.38 / $67.98	Professional	TC	$36.38	$36.38	$67.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.69 / $70.01 / $110.60	Professional		$42.69	$70.01	$110.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.42 / $16.04 / $24.99	Professional	26	$10.42	$16.04	$24.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.73 / $52.61 / $85.60	Professional	TC	$31.73	$52.61	$85.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.31 / $44.66 / $66.20	Professional		$35.31	$44.66	$66.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $11.13 / $15.90	Professional	26	$8.48	$11.13	$15.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.83 / $33.54 / $50.31	Professional	TC	$26.83	$33.54	$50.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $20.00 / $33.25	Facility	26	$15.41	$20.00	$33.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $59.22 / $91.92	Professional		$16.00	$59.22	$91.92
Sentara Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $62.16 / $111.00	Professional		$17.02	$62.16	$111.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $15.61 / $24.71	Professional	26	$10.43	$15.61	$24.71
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $33.10 / $51.87 / $82.48	Professional	TC	$33.10	$51.87	$82.48
United Facility/Professional Professional Modifier Low / Median / High Price $44.79 / $65.69 / $106.72	Professional		$44.79	$65.69	$106.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.26 / $15.50 / $23.60	Professional	26	$10.26	$15.50	$23.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.31 / $51.07 / $81.41	Professional	TC	$34.31	$51.07	$81.41