Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.08 / $142.54 / $268.81	Facility	26	$80.08	$142.54	$268.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.16 / $179.32 / $357.69	Professional		$153.16	$179.32	$357.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.37 / $88.06 / $180.99	Professional	26	$78.37	$88.06	$180.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.50 / $205.73 / $288.56	Professional		$163.50	$205.73	$288.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.05 / $103.10 / $144.51	Professional	26	$82.05	$103.10	$144.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $200.54 / $200.54 / $823.37	Professional		$200.54	$200.54	$823.37
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $103.20 / $103.20 / $195.05	Professional	26	$103.20	$103.20	$195.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.96 / $248.77 / $432.72	Professional		$143.96	$248.77	$432.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.88 / $117.73 / $212.88	Professional	26	$72.88	$117.73	$212.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.25 / $206.61 / $251.48	Professional		$167.25	$206.61	$251.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $80.43 / $102.19 / $126.97	Professional	26	$80.43	$102.19	$126.97
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $124.55 / $189.00 / $272.82	Facility	26	$124.55	$189.00	$272.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $170.36 / $325.00	Professional		$114.00	$170.36	$325.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $102.15 / $221.49 / $414.78	Professional		$102.15	$221.49	$414.78
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $98.83 / $129.05 / $202.71	Professional	26	$98.83	$129.05	$202.71
United Facility/Professional Professional Modifier Low / Median / High Price $142.87 / $221.28 / $362.00	Professional		$142.87	$221.28	$362.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.04 / $106.42 / $174.37	Professional	26	$71.04	$106.42	$174.37