Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.00 / $168.29 / $396.49	Facility	26	$125.00	$168.29	$396.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $125.00 / $300.00	Professional	26	$90.00	$125.00	$300.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.01 / $129.13 / $181.10	Professional	26	$101.01	$129.13	$181.10
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $122.01 / $127.90 / $159.88	Professional	26	$122.01	$127.90	$159.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.50 / $161.93 / $251.20	Professional	26	$91.50	$161.93	$251.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $122.10 / $143.65 / $160.76	Professional	26	$122.10	$143.65	$160.76
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $179.21 / $179.21 / $179.21	Facility	26	$179.21	$179.21	$179.21
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $109.15 / $163.99 / $254.73	Professional	26	$109.15	$163.99	$254.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.71 / $146.56 / $208.59	Professional	26	$97.71	$146.56	$208.59