Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.98 / $35.72 / $51.60	Facility	26	$28.98	$35.72	$51.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.98 / $89.54 / $112.34	Professional		$80.98	$89.54	$112.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.54 / $31.85 / $41.63	Professional	26	$28.54	$31.85	$41.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.05 / $104.63 / $145.69	Professional		$82.05	$104.63	$145.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $36.54 / $50.75	Professional	26	$28.58	$36.54	$50.75
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.13 / $104.13 / $192.13	Professional		$104.13	$104.13	$192.13
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.26 / $34.26 / $63.20	Professional	26	$34.26	$34.26	$63.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.04 / $36.04 / $36.04	Facility	26	$36.04	$36.04	$36.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.34 / $118.85 / $197.84	Professional		$92.34	$118.85	$197.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.72 / $41.44 / $67.18	Professional	26	$31.72	$41.44	$67.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $100.25 / $125.31	Professional		$80.20	$100.25	$125.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.23 / $32.92 / $43.40	Professional	26	$26.23	$32.92	$43.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $36.99 / $61.64 / $88.40	Facility	26	$36.99	$61.64	$88.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $87.00 / $152.78	Professional		$45.50	$87.00	$152.78
Sentara Facility/Professional Professional Modifier Low / Median / High Price $40.60 / $101.60 / $156.59	Professional		$40.60	$101.60	$156.59
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $33.10 / $42.04 / $63.41	Professional	26	$33.10	$42.04	$63.41
United Facility/Professional Professional Modifier Low / Median / High Price $74.06 / $109.74 / $169.11	Professional		$74.06	$109.74	$169.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.16 / $37.52 / $58.33	Professional	26	$26.16	$37.52	$58.33