Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.50 / $47.50 / $133.35	Facility	26	$47.50	$47.50	$133.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.99 / $239.18 / $340.66	Professional		$196.99	$239.18	$340.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.01 / $53.46 / $67.02	Professional	26	$45.01	$53.46	$67.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.95 / $322.52 / $484.55	Professional		$223.95	$322.52	$484.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $61.49 / $93.59	Professional	26	$48.86	$61.49	$93.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $206.33 / $247.82 / $309.77	Professional		$206.33	$247.82	$309.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $47.04 / $49.34 / $61.68	Professional	26	$47.04	$49.34	$61.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.41 / $60.41 / $60.41	Facility	26	$60.41	$60.41	$60.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.28 / $317.85 / $523.88	Professional		$227.28	$317.85	$523.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.43 / $71.02 / $115.52	Professional	26	$48.43	$71.02	$115.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $315.00 / $375.05 / $444.71	Professional		$315.00	$375.05	$444.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.89 / $60.40 / $71.90	Professional	26	$48.89	$60.40	$71.90
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $51.18 / $96.70 / $164.01	Facility	26	$51.18	$96.70	$164.01
Medcost Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $225.00 / $401.00	Professional		$70.00	$225.00	$401.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $73.27 / $283.29 / $470.12	Professional		$73.27	$283.29	$470.12
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $77.40 / $118.00	Professional	26	$55.93	$77.40	$118.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.05 / $298.95 / $455.27	Professional		$191.05	$298.95	$455.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.28 / $66.94 / $110.69	Professional	26	$44.28	$66.94	$110.69