Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.30 / $24.45 / $38.14	Facility	26	$20.30	$24.45	$38.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.99 / $34.67 / $55.39	Professional		$30.99	$34.67	$55.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $22.72 / $38.14	Professional	26	$19.98	$22.72	$38.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.00 / $16.28 / $19.48	Professional	52	$15.00	$16.28	$19.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.92 / $11.64 / $18.00	Professional	TC	$9.92	$11.64	$18.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $39.96 / $55.66	Professional		$31.35	$39.96	$55.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $25.55 / $35.47	Professional	26	$19.98	$25.55	$35.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.12 / $14.36 / $20.39	Professional	TC	$11.12	$14.36	$20.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $36.22 / $74.25	Professional		$36.22	$36.22	$74.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.43 / $23.43 / $43.23	Professional	26	$23.43	$23.43	$43.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $12.79 / $12.79 / $23.60	Professional	TC	$12.79	$12.79	$23.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.15 / $25.15 / $25.15	Facility	26	$25.15	$25.15	$25.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.67 / $43.72 / $73.28	Professional		$33.67	$43.72	$73.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.94 / $28.72 / $46.49	Professional	26	$21.94	$28.72	$46.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.57 / $14.79 / $25.12	Professional	TC	$11.57	$14.79	$25.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.07 / $37.59 / $47.62	Professional		$30.07	$37.59	$47.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.36 / $22.95 / $30.19	Professional	26	$18.36	$22.95	$30.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $11.71 / $14.64 / $17.79	Professional	TC	$11.71	$14.64	$17.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $25.52 / $39.79 / $60.50	Facility	26	$25.52	$39.79	$60.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.13 / $34.00 / $58.70	Professional		$16.13	$34.00	$58.70
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.88 / $38.06 / $63.28	Professional		$13.88	$38.06	$63.28
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $22.59 / $29.04 / $43.72	Professional	26	$22.59	$29.04	$43.72
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $11.34 / $14.41 / $22.58	Professional	TC	$11.34	$14.41	$22.58
United Facility/Professional Professional Modifier Low / Median / High Price $27.23 / $39.79 / $60.44	Professional		$27.23	$39.79	$60.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $26.03 / $40.31	Professional	26	$17.82	$26.03	$40.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.66 / $13.29 / $20.51	Professional	TC	$8.66	$13.29	$20.51