Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $977.24 / $5,248.07	Facility		$123.03	$977.24	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $169.82 / $524.81	Professional		$69.18	$169.82	$524.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,570.40 / $2,951.21	Facility		$2,137.96	$2,570.40	$2,951.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $186.21 / $467.74	Professional		$75.86	$186.21	$467.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $1,737.80	Professional		$70.79	$83.18	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $501.19 / $645.65	Facility		$323.59	$501.19	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $177.83 / $446.68	Professional		$77.62	$177.83	$446.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $380.19 / $645.65	Professional		$295.12	$380.19	$645.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $251.19	Professional		$199.53	$234.42	$251.19
Medcost Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $181.97 / $457.09	Facility		$74.13	$181.97	$457.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $363.08	Professional		$134.90	$134.90	$363.08
Sentara Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $93.33 / $436.52	Facility		$72.44	$93.33	$436.52
Sentara Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $288.40 / $1,174.90	Professional		$173.78	$288.40	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $1,862.09 / $3,890.45	Facility		$309.03	$1,862.09	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $154.88 / $398.11	Professional		$64.57	$154.88	$398.11