Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $177.83	Professional		$100.00	$131.83	$177.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $204.17	Professional		$173.78	$173.78	$204.17
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $194.98	Facility		$123.03	$123.03	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $125.89	Professional		$104.71	$123.03	$125.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $208.93 / $257.04	Professional		$181.97	$208.93	$257.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $218.78	Professional		$169.82	$169.82	$218.78
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $100.00 / $223.87	Facility		$30.20	$100.00	$223.87
Sentara Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $123.03 / $263.03	Facility		$14.79	$123.03	$263.03
Sentara Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $97.72 / $251.19	Professional		$14.45	$97.72	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $97.72 / $141.25	Facility		$11.48	$97.72	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $194.98	Professional		$95.50	$117.49	$194.98