Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.69 / $86.69 / $226.26	Facility		$86.69	$86.69	$226.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $80.27 / $88.24	Professional		$59.52	$80.27	$88.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.52 / $164.80 / $208.12	Facility		$128.52	$164.80	$208.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $42.05 / $56.27	Professional		$42.05	$42.05	$56.27
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $11.24 / $17.17 / $25.71	Professional		$11.24	$17.17	$25.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4.65 / $168.21 / $383.12	Facility		$4.65	$168.21	$383.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $53.13 / $132.32	Professional		$35.15	$53.13	$132.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.43 / $82.90 / $141.19	Professional		$68.43	$82.90	$141.19
Medcost Facility/Professional Facility Modifier Low / Median / High Price $48.62 / $88.24 / $143.04	Facility		$48.62	$88.24	$143.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $130.00 / $224.83	Professional		$92.00	$130.00	$224.83
Sentara Facility/Professional Facility Modifier Low / Median / High Price $56.82 / $92.15 / $178.34	Facility		$56.82	$92.15	$178.34
Sentara Facility/Professional Professional Modifier Low / Median / High Price $56.82 / $92.15 / $184.74	Professional		$56.82	$92.15	$184.74
United Facility/Professional Facility Modifier Low / Median / High Price $19.27 / $33.43 / $59.72	Facility		$19.27	$33.43	$59.72
United Facility/Professional Professional Modifier Low / Median / High Price $38.56 / $52.93 / $73.76	Professional		$38.56	$52.93	$73.76