Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.51 / $165.76 / $501.27	Facility	26	$97.51	$165.76	$501.27
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.74 / $54.68 / $223.62	Facility	53	$46.74	$54.68	$223.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.68 / $273.38 / $519.38	Professional		$233.68	$273.38	$519.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.51 / $122.56 / $219.70	Professional	26	$97.51	$122.56	$219.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.71 / $277.45 / $418.00	Professional		$217.71	$277.45	$418.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.43 / $122.22 / $183.35	Professional	26	$96.43	$122.22	$183.35
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $269.70 / $291.93 / $867.05	Professional		$269.70	$291.93	$867.05
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $111.83 / $121.84 / $230.28	Professional	26	$111.83	$121.84	$230.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.73 / $355.65 / $600.89	Professional		$246.73	$355.65	$600.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.36 / $145.37 / $274.24	Professional	26	$106.36	$145.37	$274.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $219.83 / $271.55 / $333.82	Professional		$219.83	$271.55	$333.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.67 / $119.02 / $148.19	Professional	26	$93.67	$119.02	$148.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $118.70 / $184.00 / $286.36	Facility	26	$118.70	$184.00	$286.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $144.91 / $258.00 / $487.00	Professional		$144.91	$258.00	$487.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $136.13 / $333.58 / $579.29	Professional		$136.13	$333.58	$579.29
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $112.75 / $151.03 / $236.55	Professional	26	$112.75	$151.03	$236.55
United Facility/Professional Professional Modifier Low / Median / High Price $205.81 / $321.89 / $494.82	Professional		$205.81	$321.89	$494.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.33 / $133.81 / $218.17	Professional	26	$89.33	$133.81	$218.17