Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.50 / $52.74 / $72.90	Facility		$20.50	$52.74	$72.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $49.21 / $101.28	Facility	26	$20.50	$49.21	$101.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $44.65 / $52.74	Professional		$20.50	$44.65	$52.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $42.13 / $49.21	Professional	26	$20.50	$42.13	$49.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.93 / $15.29 / $19.30	Facility		$11.93	$15.29	$19.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.87 / $17.16 / $28.82	Professional		$14.87	$17.16	$28.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $0.02 / $0.05 / $16.85	Professional	26	$0.02	$0.05	$16.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.30 / $45.37 / $88.47	Professional		$43.30	$45.37	$88.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.13 / $40.89 / $79.73	Professional	26	$40.13	$40.89	$79.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.13 / $14.50 / $37.79	Facility		$2.13	$14.50	$37.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $43.45 / $43.45	Professional		$43.45	$43.45	$43.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	26	$40.47	$40.47	$40.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.86 / $62.14 / $69.34	Professional		$46.86	$62.14	$69.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $57.56 / $64.75	Professional	26	$43.75	$57.56	$64.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $14.91 / $33.50 / $63.56	Facility		$14.91	$33.50	$63.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.03 / $34.10 / $65.19	Facility	26	$18.03	$34.10	$65.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $74.19 / $108.67	Professional		$5.00	$74.19	$108.67
Sentara Facility/Professional Facility Modifier Low / Median / High Price $3.12 / $23.83 / $84.07	Facility		$3.12	$23.83	$84.07
Sentara Facility/Professional Professional Modifier Low / Median / High Price $13.07 / $32.81 / $4,071.00	Professional		$13.07	$32.81	$4,071.00
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $21.30 / $63.47	Professional	26	$18.32	$21.30	$63.47
United Facility/Professional Facility Modifier Low / Median / High Price $1.37 / $1.37 / $1.37	Facility		$1.37	$1.37	$1.37
United Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $25.15 / $40.27	Professional		$19.02	$25.15	$40.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.38 / $25.10 / $40.25	Professional	26	$18.38	$25.10	$40.25