Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.54 / $6.00 / $11.24	Facility	26	$2.54	$6.00	$11.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.88 / $18.45 / $29.10	Professional		$13.88	$18.45	$29.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.54 / $3.88 / $6.00	Professional	26	$2.54	$3.88	$6.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.26 / $13.78 / $23.10	Professional	TC	$11.26	$13.78	$23.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $18.09 / $26.53	Professional		$14.04	$18.09	$26.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.49 / $3.17 / $5.57	Professional	26	$2.49	$3.17	$5.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.54 / $14.54 / $21.81	Professional	TC	$11.54	$14.54	$21.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $18.97 / $18.97 / $38.89	Professional		$18.97	$18.97	$38.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $3.55 / $6.71	Professional	26	$3.55	$3.55	$6.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $15.42 / $15.42 / $28.45	Professional	TC	$15.42	$15.42	$28.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.06 / $3.06 / $3.06	Facility	26	$3.06	$3.06	$3.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.29 / $27.68 / $43.89	Professional		$16.29	$27.68	$43.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $6.04 / $9.39	Professional	26	$2.95	$6.04	$9.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.25 / $21.34 / $35.42	Professional	TC	$13.25	$21.34	$35.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13.70 / $17.12 / $25.68	Professional		$13.70	$17.12	$25.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $2.29 / $3.00 / $4.29	Professional	26	$2.29	$3.00	$4.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $11.41 / $14.26 / $21.39	Professional	TC	$11.41	$14.26	$21.39
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $5.51 / $7.00 / $10.27	Facility	26	$5.51	$7.00	$10.27
Medcost Facility/Professional Professional Modifier Low / Median / High Price $7.00 / $25.00 / $37.00	Professional		$7.00	$25.00	$37.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $6.47 / $23.84 / $41.12	Professional		$6.47	$23.84	$41.12
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $3.08 / $6.29 / $9.44	Professional	26	$3.08	$6.29	$9.44
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $13.23 / $20.39 / $33.18	Professional	TC	$13.23	$20.39	$33.18
United Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $25.04 / $42.67	Professional		$17.13	$25.04	$42.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.61 / $5.55 / $8.61	Professional	26	$3.61	$5.55	$8.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.64 / $20.12 / $34.22	Professional	TC	$13.64	$20.12	$34.22