Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.47 / $63.04 / $114.80	Facility	26	$31.47	$63.04	$114.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.99 / $103.16 / $194.72	Professional		$89.99	$103.16	$194.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $43.59 / $72.37	Professional	26	$31.37	$43.59	$72.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $120.77 / $176.26	Professional		$91.20	$120.77	$176.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $54.25 / $79.27	Professional	26	$34.36	$54.25	$79.27
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $133.80 / $139.11 / $253.52	Professional		$133.80	$139.11	$253.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.32 / $45.15 / $56.44	Professional	26	$36.32	$45.15	$56.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.06 / $56.06 / $56.06	Facility	26	$56.06	$56.06	$56.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.54 / $129.93 / $226.94	Professional		$79.54	$129.93	$226.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $46.72 / $86.20	Professional	26	$34.40	$46.72	$86.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.27 / $121.48 / $149.82	Professional		$100.27	$121.48	$149.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.25 / $53.42 / $65.39	Professional	26	$43.25	$53.42	$65.39
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $51.72 / $58.00 / $105.81	Facility	26	$51.72	$58.00	$105.81
Medcost Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $114.02 / $196.00	Professional		$47.00	$114.02	$196.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $46.01 / $130.44 / $226.08	Professional		$46.01	$130.44	$226.08
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $38.85 / $56.55 / $88.81	Professional	26	$38.85	$56.55	$88.81
United Facility/Professional Professional Modifier Low / Median / High Price $83.50 / $120.33 / $197.64	Professional		$83.50	$120.33	$197.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.27 / $42.11 / $66.61	Professional	26	$27.27	$42.11	$66.61