Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.13 / $165.74 / $409.00	Facility		$128.13	$165.74	$409.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $483.48 / $483.48 / $483.48	Facility	25	$483.48	$483.48	$483.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.10 / $159.13 / $222.13	Professional		$124.10	$159.13	$222.13
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $354.00 / $354.00 / $354.00	Professional	25	$354.00	$354.00	$354.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.83 / $180.83 / $180.83	Facility		$180.83	$180.83	$180.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.77 / $199.64 / $256.20	Professional		$105.77	$199.64	$256.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $168.46 / $182.74 / $289.75	Professional		$168.46	$182.74	$289.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $280.49	Facility		$200.00	$200.00	$280.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $170.91 / $297.45	Professional		$65.00	$170.91	$297.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.93 / $183.73 / $229.85	Professional		$148.93	$183.73	$229.85
Medcost Facility/Professional Facility Modifier Low / Median / High Price $145.91 / $180.40 / $259.36	Facility		$145.91	$180.40	$259.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $181.00 / $200.00 / $352.00	Professional		$181.00	$200.00	$352.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $138.80 / $209.31 / $356.01	Facility		$138.80	$209.31	$356.01
Sentara Facility/Professional Professional Modifier Low / Median / High Price $141.38 / $227.36 / $389.51	Professional		$141.38	$227.36	$389.51
United Facility/Professional Professional Modifier Low / Median / High Price $112.29 / $179.65 / $268.89	Professional		$112.29	$179.65	$268.89