Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $794.33 / $1,096.48	Facility		$93.33	$794.33	$1,096.48
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $398.11 / $741.31 / $1,380.38	Facility	25	$398.11	$741.31	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $165.96	Professional		$51.29	$67.61	$165.96
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $63.10 / $125.89 / $295.12	Professional	25	$63.10	$125.89	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $173.78	Professional		$67.61	$97.72	$173.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $109.65	Professional		$70.79	$87.10	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,288.25 / $1,819.70	Facility		$1,000.00	$1,288.25	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $154.88	Professional		$58.88	$81.28	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $223.87	Professional		$66.07	$83.18	$223.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $131.83	Professional		$63.10	$77.62	$131.83
Medcost Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $85.11 / $147.91	Facility		$61.66	$85.11	$147.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Sentara Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $79.43 / $134.90	Facility		$61.66	$79.43	$134.90
Sentara Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $79.43 / $134.90	Professional		$63.10	$79.43	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $125.89	Professional		$48.98	$72.44	$125.89