Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.32 / $47.83 / $113.37	Facility	26	$26.32	$47.83	$113.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.55 / $209.81 / $305.43	Professional		$159.55	$209.81	$305.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.32 / $28.01 / $51.82	Professional	26	$26.32	$28.01	$51.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.11 / $237.20 / $334.17	Professional		$174.11	$237.20	$334.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.85 / $33.21 / $46.35	Professional	26	$25.85	$33.21	$46.35
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $197.49 / $330.58 / $490.49	Professional		$197.49	$330.58	$490.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $32.26 / $40.32	Professional	26	$32.26	$32.26	$40.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.44 / $234.63 / $421.60	Professional		$148.44	$234.63	$421.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.49 / $41.10 / $65.19	Professional	26	$23.49	$41.10	$65.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.65 / $278.00 / $286.29	Professional		$199.65	$278.00	$286.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $36.97 / $38.51	Professional	26	$28.47	$36.97	$38.51
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $44.24 / $44.24 / $51.00	Facility	26	$44.24	$44.24	$51.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $211.00 / $368.00	Professional		$41.00	$211.00	$368.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $37.49 / $214.13 / $545.14	Professional		$37.49	$214.13	$545.14
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $31.64 / $41.93 / $66.40	Professional	26	$31.64	$41.93	$66.40
United Facility/Professional Professional Modifier Low / Median / High Price $125.21 / $266.58 / $437.36	Professional		$125.21	$266.58	$437.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $41.69 / $63.37	Professional	26	$25.26	$41.69	$63.37