Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.99 / $131.85 / $276.75	Facility		$108.99	$131.85	$276.75
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $252.00 / $252.00 / $252.00	Facility	25	$252.00	$252.00	$252.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $161.56 / $253.90	Professional		$108.99	$161.56	$253.90
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $193.08 / $240.52 / $389.40	Professional	25	$193.08	$240.52	$389.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.66 / $176.81 / $258.32	Professional		$125.66	$176.81	$258.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $121.86 / $121.86 / $187.02	Professional		$121.86	$121.86	$187.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.75 / $185.75 / $185.75	Facility		$185.75	$185.75	$185.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.92 / $189.00 / $294.72	Professional		$125.92	$189.00	$294.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.97 / $200.24 / $270.77	Professional		$132.97	$200.24	$270.77
Medcost Facility/Professional Facility Modifier Low / Median / High Price $109.07 / $161.57 / $237.21	Facility		$109.07	$161.57	$237.21
Medcost Facility/Professional Professional Modifier Low / Median / High Price $201.00 / $225.00 / $365.00	Professional		$201.00	$225.00	$365.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $109.75 / $164.62 / $529.14	Facility		$109.75	$164.62	$529.14
Sentara Facility/Professional Professional Modifier Low / Median / High Price $157.49 / $214.26 / $789.88	Professional		$157.49	$214.26	$789.88
United Facility/Professional Professional Modifier Low / Median / High Price $128.56 / $204.65 / $336.33	Professional		$128.56	$204.65	$336.33