Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.37 / $52.48 / $102.33	Facility		$5.37	$52.48	$102.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $81.28 / $104.71	Facility	26	$19.95	$81.28	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $42.66 / $53.70	Professional		$15.85	$42.66	$53.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $45.71 / $102.33	Professional	26	$18.20	$45.71	$102.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $16.22 / $19.50	Facility		$12.59	$16.22	$19.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $43.65	Professional		$16.98	$16.98	$43.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $0.02 / $7.41 / $18.62	Professional	26	$0.02	$7.41	$18.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $46.77	Professional		$39.81	$41.69	$46.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $37.15 / $43.65	Professional	26	$37.15	$37.15	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.31 / $14.45 / $38.02	Facility		$3.31	$14.45	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.23 / $64.57	Professional		$46.77	$56.23	$64.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $60.26	Professional	26	$43.65	$52.48	$60.26
Medcost Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $44.67 / $83.18	Facility		$14.79	$44.67	$83.18
Medcost Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $13.49 / $102.33	Professional		$13.49	$13.49	$102.33
Sentara Facility/Professional Facility Modifier Low / Median / High Price $3.09 / $23.99 / $114.82	Facility		$3.09	$23.99	$114.82
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $33.88 / $10,000.00	Professional		$13.18	$33.88	$10,000.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.39 / $81.28	Professional	26	$18.20	$22.39	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $1.23 / $3.09 / $11.22	Facility		$1.23	$3.09	$11.22
United Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $25.12 / $40.74	Professional		$16.98	$25.12	$40.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $25.12 / $40.74	Professional	26	$16.98	$25.12	$40.74