Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $89.13 / $165.96	Facility		$41.69	$89.13	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $50.12	Professional		$41.69	$41.69	$50.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $218.78 / $263.03	Facility		$169.82	$218.78	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $42.66 / $52.48	Professional		$25.70	$42.66	$52.48
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $154.88 / $213.80	Professional		$89.13	$154.88	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $69.18 / $190.55	Facility		$28.84	$69.18	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $42.66 / $60.26	Professional		$36.31	$42.66	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $51.29 / $63.10	Professional		$42.66	$51.29	$63.10
Medcost Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $89.13	Professional		$34.67	$34.67	$89.13
Sentara Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $42.66 / $107.15	Facility		$29.51	$42.66	$107.15
Sentara Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $107.15	Professional		$29.51	$42.66	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $42.66 / $51.29	Facility		$17.78	$42.66	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $19.05 / $31.62	Professional		$17.78	$19.05	$31.62