Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $147.91 / $371.54	Facility	26	$48.98	$147.91	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $346.74	Professional		$120.23	$165.96	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $93.33 / $346.74	Professional	26	$53.70	$93.33	$346.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $229.09 / $371.54	Professional		$158.49	$229.09	$371.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $117.49 / $181.97	Professional	26	$72.44	$117.49	$181.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $1,698.24	Professional		$89.13	$186.21	$1,698.24
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $107.15 / $151.36	Professional	26	$100.00	$107.15	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $107.15 / $154.88	Facility	26	$22.91	$107.15	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $257.04 / $630.96	Professional		$134.90	$257.04	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $79.43 / $190.55	Professional	26	$52.48	$79.43	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $245.47	Professional		$162.18	$194.98	$245.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $102.33 / $131.83	Professional	26	$83.18	$102.33	$131.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $831.76 / $851.14	Professional		$380.19	$831.76	$851.14
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $100.00 / $199.53	Professional	26	$79.43	$100.00	$199.53
Medcost Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $660.69	Professional		$275.42	$275.42	$660.69
Sentara Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $204.17 / $691.83	Professional		$72.44	$204.17	$691.83
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $95.50 / $186.21	Professional	26	$60.26	$95.50	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $602.56	Professional		$147.91	$239.88	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $165.96	Professional	26	$47.86	$85.11	$165.96