Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $204.17	Professional		$120.23	$151.36	$204.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $223.87	Professional		$208.93	$208.93	$223.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $173.78 / $173.78	Professional		$22.39	$173.78	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $295.12	Professional		$218.78	$251.19	$295.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $181.97	Professional		$141.25	$141.25	$181.97
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $120.23 / $190.55	Facility		$28.84	$120.23	$190.55
Sentara Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $30.90 / $218.78	Facility		$16.22	$30.90	$218.78
Sentara Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $30.90 / $218.78	Professional		$16.22	$30.90	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $81.28 / $154.88	Facility		$10.23	$81.28	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $190.55	Professional		$102.33	$125.89	$190.55