Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.29 / $64.70 / $156.40	Facility	26	$35.29	$64.70	$156.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $98.23 / $159.46	Professional		$76.23	$98.23	$159.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.12 / $36.60 / $46.99	Professional	26	$29.12	$36.60	$46.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.41 / $129.76 / $197.29	Professional		$100.41	$129.76	$197.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.53 / $44.76 / $66.54	Professional	26	$35.53	$44.76	$66.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $113.06 / $154.51 / $1,082.82	Professional		$113.06	$154.51	$1,082.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $47.08 / $59.79	Professional	26	$46.07	$47.08	$59.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.12 / $45.12 / $45.12	Facility	26	$45.12	$45.12	$45.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.73 / $159.09 / $402.76	Professional		$86.73	$159.09	$402.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.71 / $52.34 / $90.28	Professional	26	$31.71	$52.34	$90.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.70 / $126.95 / $156.57	Professional		$105.70	$126.95	$156.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.56 / $43.93 / $52.94	Professional	26	$35.56	$43.93	$52.94
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $58.26 / $69.00 / $125.08	Facility	26	$58.26	$69.00	$125.08
Medcost Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $108.11 / $238.00	Professional		$55.00	$108.11	$238.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $145.76 / $411.60	Professional		$55.25	$145.76	$411.60
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $41.12 / $57.96 / $90.56	Professional	26	$41.12	$57.96	$90.56
United Facility/Professional Professional Modifier Low / Median / High Price $88.31 / $145.44 / $401.75	Professional		$88.31	$145.44	$401.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.38 / $51.10 / $83.84	Professional	26	$31.38	$51.10	$83.84