Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.30 / $30.82 / $57.22	Facility	26	$25.30	$30.82	$57.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $62.87 / $98.68	Professional		$56.75	$62.87	$98.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.69 / $28.56 / $47.29	Professional	26	$24.69	$28.56	$47.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.06 / $33.03 / $50.59	Professional	TC	$30.06	$33.03	$50.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.42 / $73.55 / $104.34	Professional		$57.42	$73.55	$104.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $31.83 / $47.75	Professional	26	$24.89	$31.83	$47.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.61 / $41.76 / $59.50	Professional	TC	$31.61	$41.76	$59.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $64.23 / $131.03	Professional		$64.23	$64.23	$131.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $28.80 / $53.14	Professional	26	$28.80	$28.80	$53.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $35.43 / $35.43 / $65.37	Professional	TC	$35.43	$35.43	$65.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $79.05 / $156.04	Professional		$60.28	$79.05	$156.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.33 / $36.03 / $57.47	Professional	26	$27.33	$36.03	$57.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.38 / $42.17 / $82.29	Professional	TC	$31.38	$42.17	$82.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.49 / $72.64 / $103.21	Professional		$56.49	$72.64	$103.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.88 / $30.03 / $42.90	Professional	26	$22.88	$30.03	$42.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $42.01 / $54.57	Professional	TC	$33.61	$42.01	$54.57
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $29.90 / $39.00 / $66.66	Facility	26	$29.90	$39.00	$66.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $49.00 / $96.00	Professional		$36.00	$49.00	$96.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $31.94 / $66.41 / $139.02	Professional		$31.94	$66.41	$139.02
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $36.94 / $54.10	Professional	26	$28.51	$36.94	$54.10
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $31.39 / $41.56 / $67.54	Professional	TC	$31.39	$41.56	$67.54
United Facility/Professional Professional Modifier Low / Median / High Price $47.07 / $67.88 / $108.54	Professional		$47.07	$67.88	$108.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $32.47 / $50.93	Professional	26	$22.05	$32.47	$50.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.64 / $35.71 / $60.27	Professional	TC	$24.64	$35.71	$60.27