Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.42 / $73.70 / $136.88	Facility	26	$62.42	$73.70	$136.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $164.25 / $256.79	Professional		$142.63	$164.25	$256.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.96 / $68.22 / $103.43	Professional	26	$60.96	$68.22	$103.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.59 / $179.18 / $251.67	Professional		$142.59	$179.18	$251.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.16 / $78.20 / $108.60	Professional	26	$61.16	$78.20	$108.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $171.60 / $316.60	Professional		$154.44	$171.60	$316.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $67.90 / $125.28	Professional	26	$67.90	$67.90	$125.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.80 / $76.80 / $76.80	Facility	26	$76.80	$76.80	$76.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.65 / $197.98 / $330.28	Professional		$148.65	$197.98	$330.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.33 / $87.52 / $141.11	Professional	26	$66.33	$87.52	$141.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.71 / $178.00 / $260.08	Professional		$138.71	$178.00	$260.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.68 / $74.39 / $106.28	Professional	26	$56.68	$74.39	$106.28
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $73.05 / $91.00 / $158.22	Facility	26	$73.05	$91.00	$158.22
Medcost Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $137.00 / $258.00	Professional		$90.00	$137.00	$258.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $80.95 / $168.92 / $299.35	Professional		$80.95	$168.92	$299.35
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $68.79 / $88.50 / $132.69	Professional	26	$68.79	$88.50	$132.69
United Facility/Professional Professional Modifier Low / Median / High Price $123.31 / $177.16 / $283.19	Professional		$123.31	$177.16	$283.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.54 / $79.00 / $122.68	Professional	26	$53.54	$79.00	$122.68