Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.12 / $409.77 / $680.30	Facility		$206.12	$409.77	$680.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.12 / $225.36 / $233.61	Professional		$206.12	$225.36	$233.61
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 / $252.84 / $493.04	Professional		$219.86	$252.84	$493.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.64 / $605.57 / $1,407.36	Facility		$178.64	$605.57	$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 $218.49 / $274.83 / $467.22	Facility		$218.49	$274.83	$467.22
Medcost Facility/Professional Professional Modifier Low / Median / High Price $377.00 / $480.95 / $659.59	Professional		$377.00	$480.95	$659.59
Sentara Facility/Professional Facility Modifier Low / Median / High Price $192.38 / $305.01 / $510.25	Facility		$192.38	$305.01	$510.25
Sentara Facility/Professional Professional Modifier Low / Median / High Price $192.38 / $312.48 / $510.25	Professional		$192.38	$312.48	$510.25
United Facility/Professional Facility Modifier Low / Median / High Price $329.80 / $329.80 / $329.80	Facility		$329.80	$329.80	$329.80
United Facility/Professional Professional Modifier Low / Median / High Price $115.43 / $164.90 / $374.12	Professional		$115.43	$164.90	$374.12