Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.15 / $35.18 / $95.92	Facility		$29.15	$35.18	$95.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.14 / $46.90 / $90.51	Professional		$32.14	$46.90	$90.51
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $62.94 / $104.38 / $108.41	Professional	25	$62.94	$104.38	$108.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $43.87 / $65.29	Professional		$32.61	$43.87	$65.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $43.01 / $67.23	Professional		$32.29	$43.01	$67.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.54 / $56.54 / $56.54	Facility		$56.54	$56.54	$56.54
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.48 / $5.48 / $5.48	Facility	AS	$5.48	$5.48	$5.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.35 / $51.56 / $104.78	Professional		$36.35	$51.56	$104.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.49 / $60.40 / $127.04	Professional		$41.49	$60.40	$127.04
Medcost Facility/Professional Facility Modifier Low / Median / High Price $38.86 / $51.56 / $84.96	Facility		$38.86	$51.56	$84.96
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $57.98 / $62.54 / $138.00	Facility	50	$57.98	$62.54	$138.00
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $7.73 / $8.34 / $18.39	Facility	80	$7.73	$8.34	$18.39
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $5.41 / $5.84 / $12.88	Facility	AS	$5.41	$5.84	$12.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $46.46 / $54.24 / $84.45	Professional		$46.46	$54.24	$84.45
Sentara Facility/Professional Facility Modifier Low / Median / High Price $37.13 / $48.98 / $92.40	Facility		$37.13	$48.98	$92.40
Sentara Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $48.98 / $92.40	Professional		$37.13	$48.98	$92.40
United Facility/Professional Professional Modifier Low / Median / High Price $29.90 / $46.71 / $79.22	Professional		$29.90	$46.71	$79.22