Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.19 / $614.48 / $997.15	Facility		$275.19	$614.48	$997.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.88 / $252.53 / $275.19	Professional		$161.88	$252.53	$275.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.75 / $323.75 / $1,576.66	Facility		$323.75	$323.75	$1,576.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.50 / $129.50 / $167.70	Professional		$129.50	$129.50	$167.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $352.83 / $539.23 / $807.19	Professional		$352.83	$539.23	$807.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $212.79 / $526.10 / $1,468.12	Facility		$212.79	$526.10	$1,468.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.15 / $194.25 / $480.43	Professional		$87.15	$194.25	$480.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $388.50 / $404.69 / $479.15	Professional		$388.50	$404.69	$479.15
Medcost Facility/Professional Facility Modifier Low / Median / High Price $234.90 / $235.79 / $291.38	Facility		$234.90	$235.79	$291.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $150.01 / $173.14 / $206.00	Professional		$150.01	$173.14	$206.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $174.40 / $362.60 / $4,071.00	Facility		$174.40	$362.60	$4,071.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $174.40 / $362.60 / $4,071.00	Professional		$174.40	$362.60	$4,071.00
United Facility/Professional Facility Modifier Low / Median / High Price $388.50 / $388.50 / $388.50	Facility		$388.50	$388.50	$388.50
United Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $145.69 / $194.25	Professional		$69.90	$145.69	$194.25