Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $112.20 / $302.00	Facility		$37.15	$112.20	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $57.54	Professional		$33.11	$39.81	$57.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $204.17	Facility		$50.12	$50.12	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $38.90	Professional		$25.12	$25.12	$38.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $354.81	Professional		$147.91	$239.88	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $128.82 / $229.09	Facility		$51.29	$128.82	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $31.62 / $57.54	Professional		$28.18	$31.62	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $74.13	Professional		$50.12	$60.26	$74.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $85.11 / $97.72	Professional		$41.69	$85.11	$97.72
Medcost Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $47.86	Facility		$37.15	$37.15	$47.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $107.15	Professional		$42.66	$72.44	$107.15
Sentara Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $70.79 / $10,000.00	Facility		$38.90	$70.79	$10,000.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $70.79 / $10,000.00	Professional		$38.90	$70.79	$10,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $50.12 / $60.26	Facility		$21.38	$50.12	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.20 / $52.48	Professional		$21.38	$30.20	$52.48