Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $31.62 / $38.02	Facility	26	$19.95	$31.62	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $37.15 / $85.11	Professional		$30.20	$37.15	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.70 / $64.57	Professional	26	$19.95	$25.70	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.02 / $22.39	Professional	TC	$10.00	$12.02	$22.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $43.65 / $66.07	Professional		$32.36	$43.65	$66.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $42.66	Professional	26	$20.89	$28.18	$42.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $15.85 / $23.99	Professional	TC	$11.75	$15.85	$23.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $33.88 / $57.54	Professional		$13.18	$33.88	$57.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $28.84	Professional	26	$20.89	$22.91	$28.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $20.42	Professional	TC	$14.79	$14.79	$20.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $69.18	Professional		$33.88	$42.66	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.18 / $45.71	Professional	26	$21.88	$28.18	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $14.79 / $25.12	Professional	TC	$11.22	$14.79	$25.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $41.69 / $52.48	Professional		$33.11	$41.69	$52.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $24.55 / $32.36	Professional	26	$19.95	$24.55	$32.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $16.98 / $20.89	Professional	TC	$13.49	$16.98	$20.89
Medcost Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	26	$41.69	$41.69	$41.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $29.51 / $51.29	Professional		$29.51	$29.51	$51.29
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $37.15 / $69.18	Professional		$14.13	$37.15	$69.18
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.18 / $42.66	Professional	26	$21.88	$28.18	$42.66
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $14.13 / $22.39	Professional	TC	$11.22	$14.13	$22.39
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.81 / $63.10	Professional		$27.54	$39.81	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.30 / $41.69	Professional	26	$18.20	$26.30	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $13.49 / $21.38	Professional	TC	$9.12	$13.49	$21.38