Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $87.10 / $223.87	Facility		$72.44	$87.10	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $162.18	Professional		$72.44	$93.33	$162.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $190.55	Facility		$177.83	$177.83	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $223.87	Professional		$107.15	$107.15	$223.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $123.03	Professional		$95.50	$95.50	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $109.65 / $109.65	Facility		$74.13	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $109.65	Professional		$81.28	$81.28	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $251.19	Professional		$125.89	$177.83	$251.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $177.83	Professional		$117.49	$117.49	$177.83
Medcost Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $128.82 / $239.88	Facility		$72.44	$128.82	$239.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $104.71 / $223.87	Professional		$95.50	$104.71	$223.87
Sentara Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $147.91 / $524.81	Facility		$100.00	$147.91	$524.81
Sentara Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $524.81	Professional		$100.00	$147.91	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $87.10 / $239.88	Facility		$60.26	$87.10	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $87.10 / $141.25	Professional		$81.28	$87.10	$141.25