Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.28 / $13.54 / $31.14	Facility	26	$11.28	$13.54	$31.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $40.78 / $48.68	Professional		$35.74	$40.78	$48.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.78 / $12.17 / $14.51	Professional	26	$10.78	$12.17	$14.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.81 / $28.43 / $33.29	Professional	TC	$24.81	$28.43	$33.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $51.12 / $72.34	Professional		$39.97	$51.12	$72.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $13.97 / $19.53	Professional	26	$11.06	$13.97	$19.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.16 / $37.21 / $53.40	Professional	TC	$29.16	$37.21	$53.40
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $57.61 / $57.61 / $114.79	Professional		$57.61	$57.61	$114.79
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 $41.60 / $41.60 / $76.75	Professional	TC	$41.60	$41.60	$76.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.33 / $54.23 / $89.56	Professional		$41.33	$54.23	$89.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.25 / $15.91 / $25.49	Professional	26	$12.25	$15.91	$25.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $38.46 / $62.91	Professional	TC	$28.78	$38.46	$62.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.10 / $50.81 / $73.80	Professional		$40.10	$50.81	$73.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $13.38 / $19.11	Professional	26	$10.19	$13.38	$19.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.91 / $37.39 / $53.79	Professional	TC	$29.91	$37.39	$53.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $14.32 / $22.63 / $33.50	Facility	26	$14.32	$22.63	$33.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $39.79 / $69.23	Professional		$16.00	$39.79	$69.23
Sentara Facility/Professional Professional Modifier Low / Median / High Price $15.13 / $44.62 / $74.63	Professional		$15.13	$44.62	$74.63
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $12.41 / $15.52 / $24.09	Professional	26	$12.41	$15.52	$24.09
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $28.11 / $35.82 / $57.35	Professional	TC	$28.11	$35.82	$57.35
United Facility/Professional Professional Modifier Low / Median / High Price $33.20 / $50.09 / $79.05	Professional		$33.20	$50.09	$79.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.90 / $14.64 / $22.15	Professional	26	$9.90	$14.64	$22.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.81 / $35.82 / $55.79	Professional	TC	$22.81	$35.82	$55.79