Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.05 / $45.47 / $106.53	Facility	26	$26.05	$45.47	$106.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.33 / $119.53 / $151.71	Professional		$98.33	$119.53	$151.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.67 / $26.05 / $35.88	Professional	26	$21.67	$26.05	$35.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.81 / $124.22 / $191.54	Professional		$99.81	$124.22	$191.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.97 / $34.22 / $52.30	Professional	26	$26.97	$34.22	$52.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $149.72 / $188.00 / $288.56	Professional	50	$149.72	$188.00	$288.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $146.96 / $156.44 / $398.76	Professional		$146.96	$156.44	$398.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.99 / $32.21 / $40.90	Professional	26	$28.99	$32.21	$40.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.77 / $155.44 / $282.17	Professional		$96.77	$155.44	$282.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.62 / $35.90 / $64.13	Professional	26	$23.62	$35.90	$64.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $124.35 / $152.38	Professional		$103.62	$124.35	$152.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.59 / $34.08 / $40.68	Professional	26	$27.59	$34.08	$40.68
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $40.25 / $45.00 / $84.28	Facility	26	$40.25	$45.00	$84.28
Medcost Facility/Professional Professional Modifier Low / Median / High Price $37.01 / $139.00 / $207.00	Professional		$37.01	$139.00	$207.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $153.29 / $295.14	Professional		$37.09	$153.29	$295.14
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $39.13 / $61.76	Professional	26	$28.87	$39.13	$61.76
United Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $155.16 / $249.18	Professional		$94.64	$155.16	$249.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.98 / $33.61 / $54.54	Professional	26	$21.98	$33.61	$54.54