Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.56 / $134.49 / $262.80	Facility	26	$75.56	$134.49	$262.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.89 / $290.18 / $494.17	Professional		$231.89	$290.18	$494.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.54 / $90.18 / $148.19	Professional	26	$66.54	$90.18	$148.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $274.77 / $351.29 / $543.79	Professional		$274.77	$351.29	$543.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $94.10 / $148.10	Professional	26	$75.45	$94.10	$148.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $388.37 / $425.32 / $1,586.23	Professional		$388.37	$425.32	$1,586.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $93.39 / $93.39 / $118.61	Professional	26	$93.39	$93.39	$118.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.74 / $497.11 / $802.83	Professional		$272.74	$497.11	$802.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.53 / $111.42 / $191.88	Professional	26	$68.53	$111.42	$191.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $289.79 / $347.75 / $426.34	Professional		$289.79	$347.75	$426.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.13 / $94.05 / $113.34	Professional	26	$76.13	$94.05	$113.34
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $115.14 / $131.18 / $263.32	Facility	26	$115.14	$131.18	$263.32
Medcost Facility/Professional Professional Modifier Low / Median / High Price $117.20 / $367.00 / $706.00	Professional		$117.20	$367.00	$706.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $122.39 / $402.20 / $688.64	Professional		$122.39	$402.20	$688.64
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $90.64 / $125.34 / $190.30	Professional	26	$90.64	$125.34	$190.30
United Facility/Professional Professional Modifier Low / Median / High Price $264.54 / $427.86 / $713.09	Professional		$264.54	$427.86	$713.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $105.31 / $165.38	Professional	26	$66.73	$105.31	$165.38