Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $104.71 / $269.15	Facility		$87.10	$104.71	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $158.49	Professional		$85.11	$104.71	$158.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $229.09	Facility		$218.78	$218.78	$229.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $229.09	Professional		$109.65	$109.65	$229.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $147.91	Professional		$114.82	$114.82	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $112.20 / $112.20	Facility		$97.72	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $112.20	Professional		$81.28	$81.28	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $218.78 / $302.00	Professional		$151.36	$218.78	$302.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $213.80	Professional		$100.00	$141.25	$213.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $141.25 / $251.19	Facility		$81.28	$141.25	$251.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $269.15	Professional		$109.65	$117.49	$269.15
Sentara Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $177.83 / $630.96	Facility		$117.49	$177.83	$630.96
Sentara Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $630.96	Professional		$117.49	$177.83	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $89.13 / $245.47	Facility		$60.26	$89.13	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $169.82	Professional		$89.13	$107.15	$169.82