Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $141.25 / $223.87	Facility		$50.12	$141.25	$223.87
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $26.30 / $26.30 / $288.40	Facility	25	$26.30	$26.30	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $169.82 / $371.54	Professional		$102.33	$169.82	$371.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $112.20 / $194.98 / $426.58	Professional	25	$112.20	$194.98	$426.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $309.03	Professional		$131.83	$190.55	$309.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $158.49	Professional		$104.71	$114.82	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $151.36 / $204.17	Facility		$120.23	$151.36	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $288.40	Professional		$125.89	$169.82	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $199.53 / $281.84	Professional		$128.82	$199.53	$281.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $239.88	Professional		$131.83	$177.83	$239.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $173.78 / $275.42	Facility		$114.82	$173.78	$275.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $302.00	Professional		$100.00	$100.00	$302.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $147.91 / $245.47	Facility		$125.89	$147.91	$245.47
Sentara Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $309.03	Professional		$154.88	$186.21	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $257.04	Professional		$100.00	$154.88	$257.04