Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $79.95 / $129.76	Facility		$42.13	$79.95	$129.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Professional		$42.13	$42.13	$42.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.35 / $205.61 / $259.64	Facility		$160.35	$205.61	$259.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $42.13 / $42.13	Professional		$29.06	$42.13	$42.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.32 / $136.50 / $204.33	Professional		$89.32	$136.50	$204.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.38 / $66.26 / $216.37	Facility		$27.38	$66.26	$216.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.91 / $42.13 / $48.40	Professional		$21.91	$42.13	$48.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.56 / $52.66 / $62.35	Professional		$50.56	$52.66	$62.35
Medcost Facility/Professional Facility Modifier Low / Median / High Price $42.13 / $42.13 / $42.13	Facility		$42.13	$42.13	$42.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $39.18 / $88.47	Professional		$34.54	$39.18	$88.47
Sentara Facility/Professional Facility Modifier Low / Median / High Price $31.47 / $50.99 / $4,071.00	Facility		$31.47	$50.99	$4,071.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $31.47 / $50.99 / $4,071.00	Professional		$31.47	$50.99	$4,071.00
United Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $21.07 / $31.60	Professional		$17.69	$21.07	$31.60