Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.94 / $104.73 / $193.03	Professional		$82.94	$104.73	$193.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.22 / $23.46 / $45.79	Professional	26	$21.22	$23.46	$45.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.21 / $39.21 / $81.81	Professional		$39.21	$39.21	$81.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $11.23 / $23.43	Professional	26	$11.23	$11.23	$23.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $136.91 / $136.91 / $160.18	Professional		$136.91	$136.91	$160.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.05 / $30.05 / $39.11	Professional	26	$30.05	$30.05	$39.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $78.78 / $222.13	Professional		$44.27	$78.78	$222.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $15.59 / $50.38	Professional	26	$12.17	$15.59	$50.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $169.62 / $192.75	Professional		$129.31	$169.62	$192.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.06 / $32.58 / $42.96	Professional	26	$25.06	$32.58	$42.96
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $45.00 / $50.84 / $83.00	Facility	26	$45.00	$50.84	$83.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $109.00 / $216.00	Professional		$35.00	$109.00	$216.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $38.01 / $165.81 / $262.02	Professional		$38.01	$165.81	$262.02
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $28.96 / $38.88 / $59.02	Professional	26	$28.96	$38.88	$59.02
United Facility/Professional Professional Modifier Low / Median / High Price $67.66 / $110.68 / $227.36	Professional		$67.66	$110.68	$227.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $28.04 / $52.85	Professional	26	$16.82	$28.04	$52.85