Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $131.83 / $467.74	Facility	26	$67.61	$131.83	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $316.23	Professional		$128.82	$165.96	$316.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $162.18	Professional	26	$57.54	$72.44	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $234.42 / $338.84	Professional		$165.96	$234.42	$338.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $100.00 / $144.54	Professional	26	$72.44	$100.00	$144.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $173.78 / $489.78	Professional		$72.44	$173.78	$489.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $81.28 / $123.03	Professional	26	$74.13	$81.28	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $208.93 / $371.54	Professional		$138.04	$208.93	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $162.18	Professional	26	$61.66	$91.20	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $204.17 / $257.04	Professional		$162.18	$204.17	$257.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $83.18 / $104.71	Professional	26	$66.07	$83.18	$104.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $288.40	Professional		$213.80	$269.15	$288.40
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $138.04 / $141.25	Professional	26	$109.65	$138.04	$141.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $281.84	Professional		$112.20	$112.20	$281.84
Sentara Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $181.97 / $380.19	Professional		$91.20	$181.97	$380.19
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $102.33 / $158.49	Professional	26	$77.62	$102.33	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $302.00	Professional		$131.83	$177.83	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $79.43 / $134.90	Professional	26	$57.54	$79.43	$134.90