Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.89 / $78.25 / $163.18	Facility	26	$44.89	$78.25	$163.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.06 / $202.99 / $258.70	Professional		$165.06	$202.99	$258.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $51.42 / $82.12	Professional	26	$40.90	$51.42	$82.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.15 / $246.04 / $359.63	Professional		$177.15	$246.04	$359.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.23 / $66.23 / $96.75	Professional	26	$51.23	$66.23	$96.75
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $206.33 / $232.47 / $442.94	Professional		$206.33	$232.47	$442.94
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $54.67 / $68.34	Professional	26	$51.54	$54.67	$68.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.29 / $68.29 / $68.29	Facility	26	$68.29	$68.29	$68.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.11 / $248.13 / $469.56	Professional		$153.11	$248.13	$469.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.91 / $64.80 / $122.54	Professional	26	$43.91	$64.80	$122.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.66 / $247.99 / $304.05	Professional		$206.66	$247.99	$304.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.30 / $65.84 / $79.81	Professional	26	$53.30	$65.84	$79.81
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $70.86 / $82.00 / $167.38	Facility	26	$70.86	$82.00	$167.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $229.00 / $387.39	Professional		$67.00	$229.00	$387.39
Sentara Facility/Professional Professional Modifier Low / Median / High Price $71.66 / $235.12 / $508.21	Professional		$71.66	$235.12	$508.21
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $56.63 / $77.83 / $118.75	Professional	26	$56.63	$77.83	$118.75
United Facility/Professional Professional Modifier Low / Median / High Price $140.62 / $225.29 / $409.83	Professional		$140.62	$225.29	$409.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.55 / $67.06 / $109.21	Professional	26	$43.55	$67.06	$109.21