Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $155.65 / $240.92	Facility	26	$118.59	$155.65	$240.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $525.00 / $730.14	Professional		$400.00	$525.00	$730.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.51 / $121.79 / $155.65	Professional	26	$70.51	$121.79	$155.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.14 / $500.06 / $687.76	Professional		$392.14	$500.06	$687.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.23 / $81.91 / $112.65	Professional	26	$64.23	$81.91	$112.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $507.11 / $836.19 / $1,697.27	Professional		$507.11	$836.19	$1,697.27
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $78.77 / $88.22 / $153.60	Professional	26	$78.77	$88.22	$153.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.35 / $581.16 / $1,129.74	Professional		$331.35	$581.16	$1,129.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.27 / $93.59 / $179.14	Professional	26	$53.27	$93.59	$179.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $397.19 / $476.63 / $592.74	Professional		$397.19	$476.63	$592.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.34 / $80.81 / $99.66	Professional	26	$67.34	$80.81	$99.66
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.56 / $116.77 / $171.16	Facility	26	$91.56	$116.77	$171.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $96.93 / $481.00 / $786.00	Professional		$96.93	$481.00	$786.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $89.78 / $468.38 / $994.43	Professional		$89.78	$468.38	$994.43
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $70.59 / $97.42 / $163.35	Professional	26	$70.59	$97.42	$163.35
United Facility/Professional Professional Modifier Low / Median / High Price $353.59 / $474.73 / $835.31	Professional		$353.59	$474.73	$835.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.57 / $89.20 / $158.37	Professional	26	$54.57	$89.20	$158.37