Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.33 / $43.90 / $89.15	Facility	26	$21.33	$43.90	$89.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.02 / $109.90 / $177.19	Professional		$96.02	$109.90	$177.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.32 / $34.07 / $59.08	Professional	26	$21.32	$34.07	$59.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.31 / $136.16 / $199.19	Professional		$94.31	$136.16	$199.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.40 / $42.27 / $61.66	Professional	26	$25.40	$42.27	$61.66
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $118.55 / $132.37 / $251.73	Professional		$118.55	$132.37	$251.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.46 / $34.99 / $43.74	Professional	26	$24.46	$34.99	$43.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.71 / $124.66 / $252.90	Professional		$84.71	$124.66	$252.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.61 / $33.03 / $78.52	Professional	26	$23.61	$33.03	$78.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.95 / $137.93 / $169.74	Professional		$114.95	$137.93	$169.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.33 / $42.41 / $51.10	Professional	26	$34.33	$42.41	$51.10
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $33.93 / $40.00 / $82.34	Facility	26	$33.93	$40.00	$82.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $115.00 / $192.00	Professional		$31.00	$115.00	$192.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $127.13 / $277.81	Professional		$35.86	$127.13	$277.81
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $27.17 / $42.75 / $86.10	Professional	26	$27.17	$42.75	$86.10
United Facility/Professional Professional Modifier Low / Median / High Price $73.22 / $122.84 / $214.70	Professional		$73.22	$122.84	$214.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.92 / $36.46 / $70.81	Professional	26	$20.92	$36.46	$70.81