Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $3,991.00 / $8,920.00	Facility		$136.66	$3,991.00	$8,920.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.78 / $136.66 / $157.88	Professional		$115.78	$136.66	$157.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,060.00 / $3,693.00 / $4,290.00	Facility		$3,060.00	$3,693.00	$4,290.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.56 / $138.78 / $192.03	Professional		$108.56	$138.78	$192.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $204.61 / $411.27	Professional		$204.61	$204.61	$411.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.16 / $610.00 / $867.88	Facility		$138.16	$610.00	$867.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.21 / $156.85 / $307.02	Professional		$116.21	$156.85	$307.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.69 / $144.62 / $213.36	Professional		$115.69	$144.62	$213.36
Medcost Facility/Professional Facility Modifier Low / Median / High Price $123.90 / $156.46 / $231.25	Facility		$123.90	$156.46	$231.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $183.98 / $285.74	Professional		$51.00	$183.98	$285.74
Sentara Facility/Professional Facility Modifier Low / Median / High Price $121.15 / $153.18 / $283.29	Facility		$121.15	$153.18	$283.29
Sentara Facility/Professional Professional Modifier Low / Median / High Price $121.15 / $153.18 / $283.29	Professional		$121.15	$153.18	$283.29
United Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $2,774.00 / $5,226.00	Facility		$490.00	$2,774.00	$5,226.00
United Facility/Professional Professional Modifier Low / Median / High Price $94.22 / $138.72 / $225.95	Professional		$94.22	$138.72	$225.95