Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.42 / $623.32 / $3,633.00	Facility		$117.42	$623.32	$3,633.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.43 / $104.48 / $206.01	Professional		$54.43	$104.48	$206.01
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 $52.84 / $100.18 / $154.85	Professional		$52.84	$100.18	$154.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $49.13 / $49.13 / $974.00	Professional		$49.13	$49.13	$974.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.46 / $95.46 / $95.46	Facility		$95.46	$95.46	$95.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.17 / $118.28 / $201.86	Professional		$57.17	$118.28	$201.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $116.96 / $131.36 / $156.38	Professional		$116.96	$131.36	$156.38
Medcost Facility/Professional Facility Modifier Low / Median / High Price $54.43 / $104.28 / $196.82	Facility		$54.43	$104.28	$196.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $133.00 / $154.97 / $233.00	Professional		$133.00	$154.97	$233.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $57.98 / $83.51 / $1,098.00	Facility		$57.98	$83.51	$1,098.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $112.65 / $163.33 / $1,098.00	Professional		$112.65	$163.33	$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 $90.94 / $132.66 / $229.96	Professional		$90.94	$132.66	$229.96