Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.04 / $21.43 / $48.95	Facility	26	$18.04	$21.43	$48.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.34 / $74.02 / $95.17	Professional		$63.34	$74.02	$95.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $20.47 / $24.91	Professional	26	$17.11	$20.47	$24.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $82.92 / $137.09	Professional		$63.43	$82.92	$137.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $22.40 / $37.03	Professional	26	$17.51	$22.40	$37.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $76.06 / $143.77	Professional		$76.06	$76.06	$143.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $19.57 / $37.01	Professional	26	$19.57	$19.57	$37.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.80 / $21.80 / $21.80	Facility	26	$21.80	$21.80	$21.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $84.52 / $156.85	Professional		$41.36	$84.52	$156.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $25.40 / $38.95	Professional	26	$18.45	$25.40	$38.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $84.73 / $100.14	Professional		$65.48	$84.73	$100.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.28 / $23.40 / $27.05	Professional	26	$18.28	$23.40	$27.05
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $20.77 / $34.67 / $51.00	Facility	26	$20.77	$34.67	$51.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $26.00 / $67.00 / $113.00	Professional		$26.00	$67.00	$113.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $20.48 / $65.54 / $140.88	Professional		$20.48	$65.54	$140.88
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $19.25 / $25.99 / $43.12	Professional	26	$19.25	$25.99	$43.12
United Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $70.01 / $144.88	Professional		$35.29	$70.01	$144.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.22 / $22.85 / $35.45	Professional	26	$15.22	$22.85	$35.45