Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.12 / $23.92 / $53.59	Facility	26	$13.12	$23.92	$53.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.83 / $82.41 / $97.38	Professional		$64.83	$82.41	$97.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $13.37 / $17.32	Professional	26	$11.81	$13.37	$17.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $116.54 / $171.90	Professional		$69.56	$116.54	$171.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $17.22 / $25.96	Professional	26	$13.53	$17.22	$25.96
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $98.91 / $116.73 / $210.23	Professional		$98.91	$116.73	$210.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $17.11 / $21.73	Professional	26	$17.05	$17.11	$21.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $98.60 / $197.00	Professional		$69.84	$98.60	$197.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.15 / $19.68 / $33.14	Professional	26	$12.15	$19.68	$33.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $99.73 / $119.68 / $146.66	Professional		$99.73	$119.68	$146.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $16.73 / $19.93	Professional	26	$13.55	$16.73	$19.93
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.00 / $22.68 / $46.00	Facility	26	$21.00	$22.68	$46.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $88.00 / $150.88	Professional		$20.39	$88.00	$150.88
Sentara Facility/Professional Professional Modifier Low / Median / High Price $20.95 / $97.38 / $187.13	Professional		$20.95	$97.38	$187.13
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $15.76 / $21.37 / $32.45	Professional	26	$15.76	$21.37	$32.45
United Facility/Professional Professional Modifier Low / Median / High Price $65.02 / $98.00 / $163.29	Professional		$65.02	$98.00	$163.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $17.86 / $29.45	Professional	26	$11.80	$17.86	$29.45