Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $380.19 / $645.65	Facility		$190.55	$380.19	$645.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $245.47	Professional		$144.54	$144.54	$245.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $380.19	Professional		$218.78	$251.19	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $229.09	Professional		$162.18	$190.55	$229.09
Medcost Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $295.12	Facility		$190.55	$190.55	$295.12
Sentara Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $190.55 / $257.04	Facility		$169.82	$190.55	$257.04
Sentara Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $190.55 / $257.04	Professional		$169.82	$190.55	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $181.97 / $269.15	Facility		$162.18	$181.97	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $213.80	Professional		$169.82	$204.17	$213.80