Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.97 / $26.55 / $96.38	Facility	26	$21.97	$26.55	$96.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.85 / $134.75 / $154.37	Professional		$120.85	$134.75	$154.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.96 / $23.92 / $29.05	Professional	26	$21.96	$23.92	$29.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.38 / $171.74 / $237.03	Professional		$131.38	$171.74	$237.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.20 / $26.81 / $37.42	Professional	26	$21.20	$26.81	$37.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $151.72 / $171.07 / $313.82	Professional		$151.72	$171.07	$313.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $22.67 / $42.85	Professional	26	$22.67	$22.67	$42.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.84 / $200.74 / $345.23	Professional		$141.84	$200.74	$345.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.37 / $31.67 / $55.94	Professional	26	$22.37	$31.67	$55.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.44 / $171.80 / $203.41	Professional		$137.44	$171.80	$203.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $25.19 / $30.09	Professional	26	$20.39	$25.19	$30.09
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $28.28 / $42.30 / $67.62	Facility	26	$28.28	$42.30	$67.62
Medcost Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $170.00 / $251.02	Professional		$33.00	$170.00	$251.02
Sentara Facility/Professional Professional Modifier Low / Median / High Price $32.38 / $159.09 / $279.60	Professional		$32.38	$159.09	$279.60
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $26.55 / $33.63 / $54.07	Professional	26	$26.55	$33.63	$54.07
United Facility/Professional Professional Modifier Low / Median / High Price $124.91 / $201.04 / $327.04	Professional		$124.91	$201.04	$327.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $30.07 / $49.64	Professional	26	$20.23	$30.07	$49.64