Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.77 / $178.77 / $201.77	Facility		$178.77	$178.77	$201.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.71 / $178.77 / $296.45	Professional		$136.71	$178.77	$296.45
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $204.34 / $425.00	Professional	25	$115.53	$204.34	$425.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.81 / $185.65 / $269.58	Professional		$137.81	$185.65	$269.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $158.06 / $158.06 / $308.22	Professional		$158.06	$158.06	$308.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.19 / $194.15 / $294.38	Professional		$158.19	$194.15	$294.38
Medcost Facility/Professional Facility Modifier Low / Median / High Price $138.21 / $189.50 / $302.12	Facility		$138.21	$189.50	$302.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $213.33 / $246.90 / $391.32	Professional		$213.33	$246.90	$391.32
Sentara Facility/Professional Facility Modifier Low / Median / High Price $158.15 / $192.94 / $319.14	Facility		$158.15	$192.94	$319.14
Sentara Facility/Professional Professional Modifier Low / Median / High Price $158.15 / $192.94 / $319.14	Professional		$158.15	$192.94	$319.14
United Facility/Professional Professional Modifier Low / Median / High Price $134.69 / $193.80 / $306.70	Professional		$134.69	$193.80	$306.70