Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.29 / $139.49 / $178.91	Facility		$82.29	$139.49	$178.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.47 / $94.95	Professional		$78.37	$78.47	$94.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $162.22 / $256.27	Facility		$78.37	$162.22	$256.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.37 / $105.04	Professional		$78.37	$78.37	$105.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.47 / $78.47	Professional		$78.37	$78.47	$78.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.93 / $73.93 / $78.37	Facility		$73.93	$73.93	$78.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.37 / $78.37	Professional		$78.37	$78.37	$78.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.61 / $78.37 / $100.38	Professional		$66.61	$78.37	$100.38
Medcost Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $86.67 / $125.33	Facility		$55.00	$86.67	$125.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $102.01 / $132.00	Professional		$73.00	$102.01	$132.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $92.59 / $117.56	Facility		$78.37	$92.59	$117.56
Sentara Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $92.59 / $117.56	Professional		$78.37	$92.59	$117.56
United Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $83.07 / $89.86	Professional		$78.37	$83.07	$89.86