Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $484.14 / $552.16 / $1,097.98	Facility		$484.14	$552.16	$1,097.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $508.34 / $508.34	Professional		$484.14	$508.34	$508.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $484.14 / $1,021.54 / $1,646.08	Facility		$484.14	$1,021.54	$1,646.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $484.14 / $484.14	Professional		$484.14	$484.14	$484.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $635.72 / $723.41 / $1,091.69	Professional		$635.72	$723.41	$1,091.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $456.73 / $456.73 / $484.14	Facility		$456.73	$456.73	$484.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $484.14 / $484.14	Professional		$484.14	$484.14	$484.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $411.52 / $566.52 / $580.97	Professional		$411.52	$566.52	$580.97
Medcost Facility/Professional Facility Modifier Low / Median / High Price $484.14 / $484.14 / $634.72	Facility		$484.14	$484.14	$634.72
Sentara Facility/Professional Facility Modifier Low / Median / High Price $453.93 / $476.04 / $619.70	Facility		$453.93	$476.04	$619.70
Sentara Facility/Professional Professional Modifier Low / Median / High Price $453.93 / $476.04 / $619.70	Professional		$453.93	$476.04	$619.70
United Facility/Professional Professional Modifier Low / Median / High Price $476.32 / $484.14 / $566.52	Professional		$476.32	$484.14	$566.52