Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.73 / $250.42 / $807.85	Facility		$55.73	$250.42	$807.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $55.73 / $55.73	Professional		$53.08	$55.73	$55.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.08 / $112.00 / $180.47	Facility		$53.08	$112.00	$180.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $53.08 / $53.08	Professional		$53.08	$53.08	$53.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $82.62 / $124.67	Professional		$72.59	$82.62	$124.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.49 / $47.49 / $47.49	Facility		$47.49	$47.49	$47.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.49 / $47.49 / $47.49	Professional		$47.49	$47.49	$47.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $63.70 / $77.26	Professional		$45.12	$63.70	$77.26
Medcost Facility/Professional Facility Modifier Low / Median / High Price $41.96 / $53.28 / $94.25	Facility		$41.96	$53.28	$94.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $56.00 / $56.00 / $56.00	Professional		$56.00	$56.00	$56.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $49.47 / $51.49 / $67.94	Facility		$49.47	$51.49	$67.94
Sentara Facility/Professional Professional Modifier Low / Median / High Price $49.47 / $51.49 / $67.94	Professional		$49.47	$51.49	$67.94
United Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $53.08 / $55.87	Professional		$51.49	$53.08	$55.87