Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $99.69 / $198.22	Facility		$87.28	$99.69	$198.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $91.65 / $91.65	Professional		$87.28	$91.65	$91.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $184.16 / $296.75	Facility		$87.28	$184.16	$296.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.34 / $82.34 / $87.28	Facility		$82.34	$82.34	$87.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $87.28 / $87.28	Professional		$87.28	$87.28	$87.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.19 / $104.74 / $105.94	Professional		$74.19	$104.74	$105.94
Medcost Facility/Professional Facility Modifier Low / Median / High Price $87.28 / $87.28 / $139.58	Facility		$87.28	$87.28	$139.58
Sentara Facility/Professional Facility Modifier Low / Median / High Price $82.92 / $87.28 / $111.72	Facility		$82.92	$87.28	$111.72
Sentara Facility/Professional Professional Modifier Low / Median / High Price $82.92 / $87.28 / $111.72	Professional		$82.92	$87.28	$111.72
United Facility/Professional Professional Modifier Low / Median / High Price $85.87 / $87.28 / $109.54	Professional		$85.87	$87.28	$109.54