Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.25 / $366.79 / $643.52	Facility		$164.25	$366.79	$643.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.69 / $158.47 / $164.26	Professional		$139.69	$158.47	$164.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $193.25 / $949.82	Facility		$193.25	$193.25	$949.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $77.30 / $125.61	Professional		$77.30	$77.30	$125.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $154.60 / $301.47 / $867.64	Professional		$154.60	$301.47	$867.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.61 / $361.09 / $875.83	Facility		$125.61	$361.09	$875.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.60 / $118.70 / $318.82	Professional		$93.60	$118.70	$318.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $231.90 / $286.01	Professional		$193.25	$231.90	$286.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $164.26 / $231.90 / $337.16	Facility		$164.26	$231.90	$337.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $193.00 / $248.00 / $456.74	Professional		$193.00	$248.00	$456.74
Sentara Facility/Professional Facility Modifier Low / Median / High Price $158.47 / $216.44 / $4,071.00	Facility		$158.47	$216.44	$4,071.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $158.47 / $216.44 / $4,071.00	Professional		$158.47	$216.44	$4,071.00
United Facility/Professional Facility Modifier Low / Median / High Price $81.17 / $81.17 / $81.17	Facility		$81.17	$81.17	$81.17
United Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $100.49 / $226.77	Professional		$81.17	$100.49	$226.77