Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $109.65 / $302.00	Facility		$37.15	$109.65	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $39.81 / $57.54	Professional		$37.15	$39.81	$57.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $199.53	Facility		$50.12	$50.12	$199.53
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 / $131.83 / $229.09	Facility		$51.29	$131.83	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $57.54	Professional		$28.18	$34.67	$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 $42.66 / $54.95 / $54.95	Facility		$42.66	$54.95	$54.95
Medcost Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $43.65 / $104.71	Professional		$42.66	$43.65	$104.71
Sentara Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $75.86 / $10,000.00	Facility		$38.90	$75.86	$10,000.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $75.86 / $10,000.00	Professional		$38.90	$75.86	$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