Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.92 / $13.82 / $30.33	Facility	26	$10.92	$13.82	$30.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.82 / $44.95 / $73.58	Professional		$39.82	$44.95	$73.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $12.10 / $20.46	Professional	26	$10.68	$12.10	$20.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.23 / $32.79 / $53.26	Professional	TC	$28.23	$32.79	$53.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $51.81 / $73.12	Professional		$40.28	$51.81	$73.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $13.59 / $18.98	Professional	26	$10.76	$13.59	$18.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.76 / $38.04 / $54.50	Professional	TC	$29.76	$38.04	$54.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $59.04 / $118.08	Professional		$59.04	$59.04	$118.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $16.01 / $29.54	Professional	26	$16.01	$16.01	$29.54
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.03 / $43.03 / $79.40	Professional	TC	$43.03	$43.03	$79.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.51 / $56.84 / $97.08	Professional		$43.51	$56.84	$97.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.87 / $15.56 / $24.71	Professional	26	$11.87	$15.56	$24.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.52 / $40.79 / $69.52	Professional	TC	$31.52	$40.79	$69.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $51.56 / $69.23	Professional		$40.72	$51.56	$69.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $12.97 / $18.53	Professional	26	$9.88	$12.97	$18.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.84 / $38.54 / $48.34	Professional	TC	$30.84	$38.54	$48.34
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $14.08 / $22.63 / $32.60	Facility	26	$14.08	$22.63	$32.60
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $44.00 / $75.00	Professional		$16.00	$44.00	$75.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.96 / $46.64 / $82.46	Professional		$14.96	$46.64	$82.46
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $15.33 / $23.56	Professional	26	$12.10	$15.33	$23.56
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $31.00 / $38.90 / $62.42	Professional	TC	$31.00	$38.90	$62.42
United Facility/Professional Professional Modifier Low / Median / High Price $35.21 / $52.81 / $81.69	Professional		$35.21	$52.81	$81.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $14.20 / $22.00	Professional	26	$9.72	$14.20	$22.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.22 / $38.02 / $58.64	Professional	TC	$25.22	$38.02	$58.64