Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $162.18 / $363.08	Facility		$54.95	$162.18	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $60.26 / $109.65	Professional		$48.98	$60.26	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $295.12	Facility		$74.13	$74.13	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $53.70	Professional		$30.20	$30.20	$53.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $123.03 / $186.21	Professional		$60.26	$123.03	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $181.97 / $346.74	Facility		$74.13	$181.97	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $46.77 / $125.89	Professional		$36.31	$46.77	$125.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $102.33	Professional		$74.13	$81.28	$102.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $100.00 / $128.82	Facility		$58.88	$100.00	$128.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $112.20 / $154.88	Professional		$48.98	$112.20	$154.88
Sentara Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $89.13 / $10,000.00	Facility		$61.66	$89.13	$10,000.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $10,000.00	Professional		$61.66	$91.20	$10,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $74.13 / $87.10	Facility		$50.12	$74.13	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.02 / $95.50	Professional		$30.90	$38.02	$95.50