Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $401.11 / $511.36 / $1,283.68	Facility		$401.11	$511.36	$1,283.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $416.78	Professional		$416.78	$416.78	$416.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,582.93 / $2,029.72 / $2,563.19	Facility		$1,582.93	$2,029.72	$2,563.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $599.16	Professional		$416.78	$416.78	$599.16
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $1,833.83	Professional		$416.78	$416.78	$1,833.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $270.91 / $696.24 / $2,135.39	Facility		$270.91	$696.24	$2,135.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $507.69 / $608.27	Professional		$416.78	$507.69	$608.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $500.14 / $616.83	Professional		$416.78	$500.14	$616.83
Medcost Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $533.48 / $771.04	Facility		$416.78	$533.48	$771.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $618.96 / $729.37 / $1,000.27	Professional		$618.96	$729.37	$1,000.27
Sentara Facility/Professional Facility Modifier Low / Median / High Price $311.33 / $416.78 / $773.79	Facility		$311.33	$416.78	$773.79
Sentara Facility/Professional Professional Modifier Low / Median / High Price $311.33 / $416.78 / $787.71	Professional		$311.33	$416.78	$787.71
United Facility/Professional Facility Modifier Low / Median / High Price $375.10 / $416.78 / $625.16	Facility		$375.10	$416.78	$625.16
United Facility/Professional Professional Modifier Low / Median / High Price $173.49 / $214.80 / $479.30	Professional		$173.49	$214.80	$479.30