Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $114.82	Facility		$109.65	$109.65	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $109.65 / $138.04	Professional		$81.28	$109.65	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $181.97	Professional		$109.65	$134.90	$181.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $125.89 / $199.53	Professional		$56.23	$125.89	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $776.25 / $870.96	Facility		$524.81	$776.25	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $245.47	Professional		$97.72	$141.25	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $141.25 / $234.42	Professional		$117.49	$141.25	$234.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $194.98 / $208.93	Professional		$169.82	$194.98	$208.93
Medcost Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $144.54 / $223.87	Facility		$100.00	$144.54	$223.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $102.33 / $257.04	Professional		$53.70	$102.33	$257.04
Sentara Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $93.33 / $181.97	Facility		$63.10	$93.33	$181.97
Sentara Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $134.90 / $223.87	Professional		$67.61	$134.90	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $213.80	Professional		$97.72	$128.82	$213.80