Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.12 / $409.77 / $610.20	Facility		$206.12	$409.77	$610.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.12 / $209.54 / $225.36	Professional		$206.12	$209.54	$225.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,043.80 / $1,338.42 / $1,690.20	Facility		$1,043.80	$1,338.42	$1,690.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.93 / $109.93 / $178.63	Professional		$109.93	$109.93	$178.63
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $219.86 / $219.86 / $428.73	Professional		$219.86	$219.86	$428.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.64 / $511.51 / $1,407.36	Facility		$178.64	$511.51	$1,407.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.90 / $334.90 / $401.25	Professional		$334.90	$334.90	$401.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $329.80 / $406.75	Professional		$274.83	$329.80	$406.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $209.54 / $274.83 / $419.08	Facility		$209.54	$274.83	$419.08
Medcost Facility/Professional Professional Modifier Low / Median / High Price $377.00 / $544.16 / $659.59	Professional		$377.00	$544.16	$659.59
Sentara Facility/Professional Facility Modifier Low / Median / High Price $192.11 / $293.24 / $510.25	Facility		$192.11	$293.24	$510.25
Sentara Facility/Professional Professional Modifier Low / Median / High Price $192.38 / $305.01 / $510.25	Professional		$192.38	$305.01	$510.25
United Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $128.19 / $283.50	Professional		$103.54	$128.19	$283.50