Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $53.70 / $165.96	Facility		$23.44	$53.70	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $18.20 / $28.18	Professional		$15.14	$18.20	$28.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $79.43	Facility		$19.95	$19.95	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $17.38	Professional		$10.00	$10.00	$17.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $93.33 / $141.25	Professional		$16.98	$93.33	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $51.29 / $91.20	Facility		$31.62	$51.29	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $14.79 / $39.81	Professional		$10.23	$14.79	$39.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.99 / $29.51	Professional		$19.95	$23.99	$29.51
Medcost Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Medcost Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $34.67 / $52.48	Facility		$16.98	$34.67	$52.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $41.69	Professional		$16.22	$16.22	$41.69
Sentara Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $28.84 / $10,000.00	Facility		$19.05	$28.84	$10,000.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $28.84 / $10,000.00	Professional		$19.50	$28.84	$10,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $19.95 / $23.99	Facility		$16.98	$19.95	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $12.02 / $28.18	Professional		$8.51	$12.02	$28.18