Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $63.10 / $208.93	Facility	26	$31.62	$63.10	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $223.87	Professional		$83.18	$112.20	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $48.98 / $104.71	Professional	26	$32.36	$48.98	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $213.80	Professional		$100.00	$134.90	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $61.66 / $95.50	Professional	26	$38.90	$61.66	$95.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $117.49 / $245.47	Professional		$45.71	$117.49	$245.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $51.29 / $72.44	Professional	26	$33.88	$51.29	$72.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $229.09	Professional		$79.43	$125.89	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $93.33	Professional	26	$30.90	$45.71	$93.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $125.89 / $154.88	Professional		$104.71	$125.89	$154.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $69.18	Professional	26	$44.67	$54.95	$69.18
Medcost Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $257.04	Professional		$95.50	$134.90	$257.04
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $107.15	Professional	26	$48.98	$61.66	$107.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $177.83	Professional		$79.43	$79.43	$177.83
Sentara Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $114.82 / $288.40	Professional		$41.69	$114.82	$288.40
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $93.33	Professional	26	$35.48	$52.48	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $112.20 / $218.78	Professional		$69.18	$112.20	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $41.69 / $70.79	Professional	26	$25.70	$41.69	$70.79