Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.57 / $64.76 / $156.27	Facility	26	$36.57	$64.76	$156.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.03 / $94.06 / $105.32	Professional		$74.03	$94.06	$105.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.45 / $36.63 / $44.92	Professional	26	$31.45	$36.63	$44.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.19 / $122.45 / $188.52	Professional		$94.19	$122.45	$188.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $46.89 / $70.70	Professional	26	$36.97	$46.89	$70.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $99.44 / $120.24 / $380.28	Professional		$99.44	$120.24	$380.28
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.60 / $44.60 / $56.64	Professional	26	$44.60	$44.60	$56.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.27 / $47.27 / $47.27	Facility	26	$47.27	$47.27	$47.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.90 / $135.77 / $240.97	Professional		$82.90	$135.77	$240.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.26 / $53.29 / $91.36	Professional	26	$33.26	$53.29	$91.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.65 / $128.18 / $155.08	Professional		$106.65	$128.18	$155.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.83 / $46.73 / $55.63	Professional	26	$37.83	$46.73	$55.63
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $54.85 / $70.00 / $123.45	Facility	26	$54.85	$70.00	$123.45
Medcost Facility/Professional Professional Modifier Low / Median / High Price $56.00 / $87.94 / $165.00	Professional		$56.00	$87.94	$165.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $54.21 / $117.59 / $203.79	Professional		$54.21	$117.59	$203.79
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $42.59 / $57.21 / $90.58	Professional	26	$42.59	$57.21	$90.58
United Facility/Professional Professional Modifier Low / Median / High Price $86.74 / $127.94 / $198.03	Professional		$86.74	$127.94	$198.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.38 / $48.23 / $84.36	Professional	26	$33.38	$48.23	$84.36