Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.82 / $56.15 / $141.36	Facility	26	$31.82	$56.15	$141.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.64 / $61.28 / $104.33	Professional		$49.64	$61.28	$104.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.28 / $32.84 / $55.85	Professional	26	$30.28	$32.84	$55.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.55 / $67.20 / $102.36	Professional		$52.55	$67.20	$102.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.27 / $41.27 / $57.45	Professional	26	$32.27	$41.27	$57.45
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $78.81 / $100.80 / $145.83	Professional	50	$78.81	$100.80	$145.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $80.93 / $435.06	Professional		$77.95	$80.93	$435.06
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $46.54 / $48.06 / $90.83	Professional	26	$46.54	$48.06	$90.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.95 / $39.95 / $39.95	Facility	26	$39.95	$39.95	$39.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.57 / $100.89 / $158.81	Professional		$48.57	$100.89	$158.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.62 / $53.96 / $85.76	Professional	26	$28.62	$53.96	$85.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $65.47 / $79.95	Professional		$53.00	$65.47	$79.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.03 / $40.46 / $49.91	Professional	26	$32.03	$40.46	$49.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $64.63 / $82.00 / $105.58	Facility	26	$64.63	$82.00	$105.58
Medcost Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $78.00 / $153.00	Professional		$55.00	$78.00	$153.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $47.81 / $92.25 / $161.58	Professional		$47.81	$92.25	$161.58
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $62.04 / $85.19	Professional	26	$40.24	$62.04	$85.19
United Facility/Professional Professional Modifier Low / Median / High Price $50.18 / $83.12 / $165.40	Professional		$50.18	$83.12	$165.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.33 / $45.23 / $75.80	Professional	26	$29.33	$45.23	$75.80