Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.15 / $91.66 / $218.61	Facility		$48.15	$91.66	$218.61
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $9.16 / $149.18 / $324.57	Facility	25	$9.16	$149.18	$324.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $99.31 / $183.31	Professional		$66.09	$99.31	$183.31
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $65.51 / $123.57 / $248.25	Professional	25	$65.51	$123.57	$248.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.98 / $125.27 / $191.18	Professional		$85.98	$125.27	$191.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $65.77 / $84.63 / $128.25	Professional		$65.77	$84.63	$128.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $136.00 / $256.98	Facility		$120.00	$136.00	$256.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $122.50 / $211.34	Professional		$80.23	$122.50	$211.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.61 / $147.82 / $225.15	Professional		$119.61	$147.82	$225.15
Medcost Facility/Professional Facility Modifier Low / Median / High Price $77.78 / $112.03 / $171.07	Facility		$77.78	$112.03	$171.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $150.00 / $226.00	Professional		$120.00	$150.00	$226.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $75.72 / $103.36 / $165.09	Facility		$75.72	$103.36	$165.09
Sentara Facility/Professional Professional Modifier Low / Median / High Price $102.10 / $135.32 / $227.18	Professional		$102.10	$135.32	$227.18
United Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $111.92 / $192.17	Professional		$71.23	$111.92	$192.17