Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $2,630.27 / $3,162.28	Facility		$199.53	$2,630.27	$3,162.28
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $446.68 / $3,162.28 / $3,467.37	Facility	25	$446.68	$3,162.28	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $645.65	Professional		$169.82	$245.47	$645.65
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $354.81 / $831.76	Professional	25	$173.78	$354.81	$831.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $323.59 / $524.81	Professional		$223.87	$323.59	$524.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $251.19 / $346.74	Professional		$234.42	$251.19	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Facility		$5,495.41	$5,495.41	$5,495.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $512.86	Professional		$208.93	$288.40	$512.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $512.86	Professional		$275.42	$346.74	$512.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $309.03 / $436.52	Professional		$245.47	$309.03	$436.52
Medcost Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $302.00 / $489.78	Facility		$199.53	$302.00	$489.78
Medcost Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $537.03	Professional		$173.78	$173.78	$537.03
Sentara Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $257.04 / $407.38	Facility		$218.78	$257.04	$407.38
Sentara Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $512.86	Professional		$269.15	$316.23	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility		$3,890.45	$3,890.45	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $446.68	Professional		$181.97	$269.15	$446.68