Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.75 / $72.50 / $135.51	Facility	26	$60.75	$72.50	$135.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $123.41 / $198.94	Professional		$103.20	$123.41	$198.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.41 / $67.48 / $113.10	Professional	26	$57.41	$67.48	$113.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $125.34 / $197.50	Professional		$90.76	$125.34	$197.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.30 / $72.59 / $114.37	Professional	26	$52.30	$72.59	$114.37
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $106.69 / $109.70 / $213.91	Professional		$106.69	$109.70	$213.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $57.16 / $60.17 / $117.33	Professional	26	$57.16	$60.17	$117.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $154.15 / $269.27	Professional		$102.90	$154.15	$269.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.47 / $89.76 / $152.38	Professional	26	$62.47	$89.76	$152.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.48 / $126.47 / $158.26	Professional		$103.48	$126.47	$158.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.59 / $72.38 / $89.61	Professional	26	$58.59	$72.38	$89.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $116.75 / $142.99 / $178.48	Facility	26	$116.75	$142.99	$178.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $98.00 / $195.18	Professional		$71.00	$98.00	$195.18
Sentara Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $131.57 / $249.55	Professional		$61.75	$131.57	$249.55
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $66.84 / $91.06 / $146.60	Professional	26	$66.84	$91.06	$146.60
United Facility/Professional Professional Modifier Low / Median / High Price $98.78 / $165.54 / $256.00	Professional		$98.78	$165.54	$256.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.14 / $90.81 / $136.46	Professional	26	$55.14	$90.81	$136.46