Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.76 / $121.47 / $256.45	Facility	26	$70.76	$121.47	$256.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.81 / $164.73 / $286.20	Professional		$148.81	$164.73	$286.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.89 / $70.76 / $118.85	Professional	26	$64.89	$70.76	$118.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.43 / $198.95 / $284.05	Professional		$158.43	$198.95	$284.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.45 / $85.32 / $121.81	Professional	26	$69.45	$85.32	$121.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $183.99 / $193.54 / $541.74	Professional		$183.99	$193.54	$541.74
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $82.48 / $82.48 / $155.88	Professional	26	$82.48	$82.48	$155.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.87 / $86.87 / $86.87	Facility	26	$86.87	$86.87	$86.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $206.54 / $402.65	Professional		$138.04	$206.54	$402.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.26 / $94.08 / $176.32	Professional	26	$61.26	$94.08	$176.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.94 / $204.98 / $248.28	Professional		$165.94	$204.98	$248.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.61 / $87.18 / $107.71	Professional	26	$68.61	$87.18	$107.71
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $108.28 / $128.00 / $212.69	Facility	26	$108.28	$128.00	$212.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $150.00 / $284.00	Professional		$104.89	$150.00	$284.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $94.03 / $196.50 / $349.91	Professional		$94.03	$196.50	$349.91
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $78.53 / $104.09 / $167.85	Professional	26	$78.53	$104.09	$167.85
United Facility/Professional Professional Modifier Low / Median / High Price $133.28 / $183.21 / $302.11	Professional		$133.28	$183.21	$302.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.49 / $91.83 / $126.88	Professional	26	$57.49	$91.83	$126.88