Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.96 / $37.02 / $80.98	Facility	26	$20.96	$37.02	$80.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.93 / $116.37 / $149.54	Professional		$90.93	$116.37	$149.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.02 / $21.07 / $28.50	Professional	26	$18.02	$21.07	$28.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.56 / $151.02 / $221.02	Professional		$98.56	$151.02	$221.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.93 / $26.52 / $39.81	Professional	26	$20.93	$26.52	$39.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $123.75 / $143.65 / $280.12	Professional		$123.75	$143.65	$280.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.58 / $25.58 / $32.49	Professional	26	$25.58	$25.58	$32.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $26.63 / $26.63	Facility	26	$26.63	$26.63	$26.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.85 / $136.83 / $275.24	Professional		$94.85	$136.83	$275.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $30.60 / $52.35	Professional	26	$18.64	$30.60	$52.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.27 / $153.91 / $188.63	Professional		$128.27	$153.91	$188.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.45 / $25.26 / $31.28	Professional	26	$20.45	$25.26	$31.28
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $34.68 / $41.00 / $72.00	Facility	26	$34.68	$41.00	$72.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $125.00 / $204.00	Professional		$32.00	$125.00	$204.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $33.02 / $137.29 / $272.80	Professional		$33.02	$137.29	$272.80
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $24.71 / $32.75 / $51.39	Professional	26	$24.71	$32.75	$51.39
United Facility/Professional Professional Modifier Low / Median / High Price $87.84 / $132.30 / $233.29	Professional		$87.84	$132.30	$233.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.18 / $29.04 / $47.34	Professional	26	$19.18	$29.04	$47.34