Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.68 / $171.30 / $468.00	Facility		$124.68	$171.30	$468.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $276.11 / $276.11 / $276.11	Facility	25	$276.11	$276.11	$276.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.19 / $181.36 / $341.33	Professional		$138.19	$181.36	$341.33
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $170.40 / $280.98 / $574.75	Professional	25	$170.40	$280.98	$574.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.80 / $223.06 / $350.74	Professional		$162.80	$223.06	$350.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $136.99 / $158.62 / $267.13	Professional		$136.99	$158.62	$267.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $150.00 / $256.98	Facility		$120.00	$150.00	$256.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.10 / $233.92 / $420.35	Professional		$165.10	$233.92	$420.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.39 / $254.18 / $358.01	Professional		$205.39	$254.18	$358.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $165.61 / $223.87 / $342.35	Facility		$165.61	$223.87	$342.35
Medcost Facility/Professional Professional Modifier Low / Median / High Price $243.00 / $289.02 / $398.00	Professional		$243.00	$289.02	$398.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $168.27 / $209.17 / $349.39	Facility		$168.27	$209.17	$349.39
Sentara Facility/Professional Professional Modifier Low / Median / High Price $203.50 / $252.04 / $418.58	Professional		$203.50	$252.04	$418.58
United Facility/Professional Professional Modifier Low / Median / High Price $146.55 / $220.94 / $377.52	Professional		$146.55	$220.94	$377.52
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $88.00	Professional	25	$80.00	$80.00	$88.00