Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $100.00 / $389.05	Facility	26	$52.48	$100.00	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $588.84	Professional		$190.55	$263.03	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $134.90	Professional	26	$52.48	$66.07	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $457.09	Professional		$199.53	$275.42	$457.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $77.62 / $123.03	Professional	26	$56.23	$77.62	$123.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $281.84 / $1,288.25	Professional		$77.62	$281.84	$1,288.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $70.79 / $120.23	Professional	26	$66.07	$70.79	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $97.72	Facility	26	$14.79	$69.18	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $380.19 / $645.65	Professional		$186.21	$380.19	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $75.86 / $134.90	Professional	26	$46.77	$75.86	$134.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $295.12	Professional		$194.98	$234.42	$295.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $85.11	Professional	26	$53.70	$66.07	$85.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $616.60 / $630.96	Professional		$467.74	$616.60	$630.96
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $112.20 / $128.82	Professional	26	$89.13	$112.20	$128.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $338.84	Professional		$275.42	$275.42	$338.84
Sentara Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $316.23 / $1,047.13	Professional		$77.62	$316.23	$1,047.13
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $81.28 / $134.90	Professional	26	$61.66	$81.28	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $316.23 / $616.60	Professional		$181.97	$316.23	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $70.79 / $117.49	Professional	26	$40.74	$70.79	$117.49