Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $96.93 / $192.73	Facility		$84.57	$96.93	$192.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $85.42 / $102.28	Professional		$84.57	$85.42	$102.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $175.06 / $276.54	Facility		$84.57	$175.06	$276.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $113.35	Professional		$84.57	$84.57	$113.35
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $84.52 / $84.52 / $84.57	Professional		$84.52	$84.52	$84.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.78 / $79.78 / $84.57	Facility		$79.78	$79.78	$84.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $84.57	Professional		$84.57	$84.57	$84.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.88 / $84.57 / $101.48	Professional		$71.88	$84.57	$101.48
Medcost Facility/Professional Facility Modifier Low / Median / High Price $69.03 / $88.80 / $146.33	Facility		$69.03	$88.80	$146.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.97 / $170.00 / $262.30	Professional		$114.97	$170.00	$262.30
Sentara Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $95.74 / $126.86	Facility		$84.57	$95.74	$126.86
Sentara Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $95.74 / $126.86	Professional		$84.57	$95.74	$126.86
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $89.64 / $95.13	Professional		$84.57	$89.64	$95.13