Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.83 / $100.47 / $208.31	Facility	26	$53.83	$100.47	$208.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.34 / $263.37 / $422.00	Professional		$183.34	$263.37	$422.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $62.69 / $104.07	Professional	26	$51.94	$62.69	$104.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.08 / $241.00 / $397.65	Professional		$188.08	$241.00	$397.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.37 / $68.38 / $106.00	Professional	26	$54.37	$68.38	$106.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $284.45 / $340.57 / $1,267.32	Professional		$284.45	$340.57	$1,267.32
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $65.98 / $65.98 / $83.79	Professional	26	$65.98	$65.98	$83.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.74 / $400.98 / $628.45	Professional		$172.74	$400.98	$628.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.95 / $79.45 / $146.38	Professional	26	$48.95	$79.45	$146.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $193.51 / $232.21 / $285.20	Professional		$193.51	$232.21	$285.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.91 / $66.59 / $80.75	Professional	26	$53.91	$66.59	$80.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $91.56 / $188.58	Facility	26	$83.00	$91.56	$188.58
Medcost Facility/Professional Professional Modifier Low / Median / High Price $83.39 / $311.00 / $569.00	Professional		$83.39	$311.00	$569.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $86.73 / $345.33 / $607.95	Professional		$86.73	$345.33	$607.95
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $63.39 / $84.48 / $133.77	Professional	26	$63.39	$84.48	$133.77
United Facility/Professional Professional Modifier Low / Median / High Price $185.84 / $320.29 / $560.17	Professional		$185.84	$320.29	$560.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.52 / $76.01 / $117.00	Professional	26	$46.52	$76.01	$117.00