Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.01 / $35.42 / $84.82	Facility	26	$20.01	$35.42	$84.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.07 / $48.52 / $87.00	Professional		$40.07	$48.52	$87.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $20.71 / $33.40	Professional	26	$19.05	$20.71	$33.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $55.02 / $78.84	Professional		$43.02	$55.02	$78.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.28 / $25.94 / $35.79	Professional	26	$20.28	$25.94	$35.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $67.34 / $260.57	Professional		$64.48	$67.34	$260.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $29.26 / $30.36 / $57.38	Professional	26	$29.26	$30.36	$57.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.10 / $25.10 / $25.10	Facility	26	$25.10	$25.10	$25.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $76.15 / $121.18	Professional		$39.29	$76.15	$121.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $32.03 / $52.48	Professional	26	$18.05	$32.03	$52.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $54.83 / $66.08	Professional		$44.39	$54.83	$66.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.47 / $25.78 / $31.79	Professional	26	$20.47	$25.78	$31.79
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $40.52 / $48.00 / $67.14	Facility	26	$40.52	$48.00	$67.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $38.89 / $60.00 / $110.26	Professional		$38.89	$60.00	$110.26
Sentara Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $70.70 / $115.30	Professional		$32.10	$70.70	$115.30
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $25.38 / $37.76 / $51.57	Professional	26	$25.38	$37.76	$51.57
United Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $63.32 / $112.10	Professional		$38.97	$63.32	$112.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $28.02 / $45.29	Professional	26	$18.05	$28.02	$45.29