Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.41 / $18.78 / $18.78	Facility	26	$18.41	$18.78	$18.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $71.73 / $134.79	Professional		$68.06	$71.73	$134.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $18.78 / $37.93	Professional	26	$17.82	$18.78	$37.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.31 / $53.32 / $98.37	Professional	TC	$49.31	$53.32	$98.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.94 / $87.27 / $122.59	Professional		$67.94	$87.27	$122.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $23.55 / $33.08	Professional	26	$18.32	$23.55	$33.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.61 / $63.72 / $89.49	Professional	TC	$49.61	$63.72	$89.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $23.32 / $23.32	Facility	26	$23.32	$23.32	$23.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.51 / $102.10 / $106.94	Professional		$74.51	$102.10	$106.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $26.63 / $27.74	Professional	26	$20.30	$26.63	$27.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $54.21 / $75.70 / $77.61	Professional	TC	$54.21	$75.70	$77.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $17.00 / $19.80 / $45.88	Facility	26	$17.00	$19.80	$45.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $93.00 / $132.00	Professional		$30.74	$93.00	$132.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $24.78 / $78.22 / $166.87	Professional		$24.78	$78.22	$166.87
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $25.86 / $44.65	Professional	26	$20.16	$25.86	$44.65
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $53.72 / $69.06 / $122.27	Professional	TC	$53.72	$69.06	$122.27
United Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $108.14 / $202.50	Professional		$66.37	$108.14	$202.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $25.01 / $41.33	Professional	26	$16.67	$25.01	$41.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.38 / $83.75 / $174.11	Professional	TC	$52.38	$83.75	$174.11