Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.12 / $15.81 / $36.36	Facility	26	$13.12	$15.81	$36.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.31 / $39.32 / $62.24	Professional		$35.31	$39.32	$62.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $14.24 / $22.30	Professional	26	$12.80	$14.24	$22.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.86 / $25.06 / $35.86	Professional	TC	$21.86	$25.06	$35.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.17 / $45.17 / $63.45	Professional		$35.17	$45.17	$63.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $16.51 / $22.92	Professional	26	$12.91	$16.51	$22.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.55 / $28.83 / $41.30	Professional	TC	$22.55	$28.83	$41.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $41.87 / $41.87 / $85.83	Professional		$41.87	$41.87	$85.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.74 / $14.74 / $27.86	Professional	26	$14.74	$14.74	$27.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.42 / $27.13 / $50.06	Professional	TC	$24.42	$27.13	$50.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.14 / $82.07	Professional		$37.15	$48.14	$82.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.02 / $18.64 / $29.67	Professional	26	$14.02	$18.64	$29.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.25 / $30.42 / $53.02	Professional	TC	$22.25	$30.42	$53.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.99 / $44.72 / $65.61	Professional		$34.99	$44.72	$65.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $15.57 / $22.25	Professional	26	$11.86	$15.57	$22.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.13 / $28.91 / $42.12	Professional	TC	$23.13	$28.91	$42.12
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.52 / $20.00 / $33.92	Facility	26	$15.52	$20.00	$33.92
Medcost Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $35.00 / $61.00	Professional		$19.00	$35.00	$61.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $17.66 / $41.87 / $73.13	Professional		$17.66	$41.87	$73.13
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $18.89 / $28.05	Professional	26	$14.49	$18.89	$28.05
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $30.07 / $47.71	Professional	TC	$23.82	$30.07	$47.71
United Facility/Professional Professional Modifier Low / Median / High Price $30.04 / $43.43 / $69.72	Professional		$30.04	$43.43	$69.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $16.60 / $26.80	Professional	26	$11.18	$16.60	$26.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $26.72 / $43.28	Professional	TC	$18.30	$26.72	$43.28