Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.60 / $24.81 / $24.81	Facility	26	$20.60	$24.81	$24.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.71 / $74.42 / $86.51	Professional		$60.71	$74.42	$86.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.12 / $22.38 / $26.36	Professional	26	$20.12	$22.38	$26.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.16 / $75.41 / $108.91	Professional		$59.16	$75.41	$108.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.36 / $24.36 / $35.83	Professional	26	$19.36	$24.36	$35.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $77.01 / $77.01 / $150.16	Professional		$77.01	$77.01	$150.16
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.07 / $22.07 / $40.71	Professional	26	$22.07	$22.07	$40.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.49 / $24.49 / $24.49	Facility	26	$24.49	$24.49	$24.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $94.81 / $160.19	Professional		$71.00	$94.81	$160.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $29.31 / $47.16	Professional	26	$21.97	$29.31	$47.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $73.41 / $92.43	Professional		$58.73	$73.41	$92.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.71 / $22.29 / $29.45	Professional	26	$17.71	$22.29	$29.45
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.08 / $26.18 / $47.90	Facility	26	$26.08	$26.18	$47.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.64 / $77.00 / $130.00	Professional		$30.64	$77.00	$130.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $27.17 / $80.75 / $130.22	Professional		$27.17	$80.75	$130.22
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $22.20 / $28.42 / $44.40	Professional	26	$22.20	$28.42	$44.40
United Facility/Professional Professional Modifier Low / Median / High Price $61.82 / $90.38 / $141.97	Professional		$61.82	$90.38	$141.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $26.47 / $40.22	Professional	26	$18.05	$26.47	$40.22