Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.55 / $664.49 / $3,633.00	Facility		$118.55	$664.49	$3,633.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.09 / $105.80 / $206.56	Professional		$58.09	$105.80	$206.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,735.00 / $2,390.00 / $2,954.00	Facility		$1,735.00	$2,390.00	$2,954.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $103.42 / $157.60	Professional		$56.02	$103.42	$157.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $52.11 / $52.11 / $974.00	Professional		$52.11	$52.11	$974.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.68 / $100.68 / $100.68	Facility		$100.68	$100.68	$100.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $119.59 / $202.49	Professional		$58.48	$119.59	$202.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.03 / $133.46 / $158.88	Professional		$119.03	$133.46	$158.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $58.06 / $107.10 / $198.96	Facility		$58.06	$107.10	$198.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $134.00 / $157.00 / $234.00	Professional		$134.00	$157.00	$234.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $89.24 / $1,098.00	Facility		$61.54	$89.24	$1,098.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $165.04 / $1,098.00	Professional		$113.36	$165.04	$1,098.00
United Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $1,045.00 / $2,364.00	Facility		$296.00	$1,045.00	$2,364.00
United Facility/Professional Professional Modifier Low / Median / High Price $91.23 / $132.71 / $220.79	Professional		$91.23	$132.71	$220.79