Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $131.83 / $389.05	Facility		$56.23	$131.83	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $213.80	Professional		$56.23	$81.28	$213.80
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	25	$120.23	$120.23	$120.23
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	CQ	$57.54	$57.54	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $83.18 / $120.23	Professional		$60.26	$83.18	$120.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $199.53	Professional		$74.13	$87.10	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $79.43 / $338.84	Facility		$72.44	$79.43	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $147.91	Professional		$58.88	$85.11	$147.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $128.82	Professional		$87.10	$104.71	$128.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Medcost Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $83.18 / $125.89	Facility		$56.23	$83.18	$125.89
Medcost Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Sentara Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $102.33 / $371.54	Facility		$67.61	$102.33	$371.54
Sentara Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $102.33 / $371.54	Professional		$67.61	$102.33	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $107.15 / $107.15	Facility		$97.72	$107.15	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $117.49	Professional		$64.57	$83.18	$117.49