Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.50 / $125.00 / $259.98	Facility	26	$119.50	$125.00	$259.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $125.00 / $256.92	Professional	26	$90.00	$125.00	$256.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.03 / $78.02 / $117.62	Professional	26	$61.03	$78.02	$117.62
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $73.76 / $85.09 / $106.36	Professional	26	$73.76	$85.09	$106.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.13 / $97.79 / $151.74	Professional	26	$53.13	$97.79	$151.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $73.51 / $86.48 / $96.84	Professional	26	$73.51	$86.48	$96.84
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $80.23 / $80.23 / $107.33	Facility	26	$80.23	$80.23	$107.33
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $76.31 / $97.82 / $160.25	Professional	26	$76.31	$97.82	$160.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.35 / $94.81 / $123.98	Professional	26	$58.35	$94.81	$123.98