Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $161.66 / $321.48	Facility		$141.60	$161.66	$321.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $148.68 / $148.68	Professional		$141.60	$148.68	$148.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $298.77 / $481.44	Facility		$141.60	$298.77	$481.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $173.10 / $196.98 / $297.26	Professional		$173.10	$196.98	$297.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.59 / $133.59 / $141.60	Facility		$133.59	$133.59	$141.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $169.92 / $171.93	Professional		$120.36	$169.92	$171.93
Medcost Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $147.69 / $199.48	Facility		$141.60	$147.69	$199.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $106.00 / $106.00	Professional		$106.00	$106.00	$106.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $134.52 / $141.60 / $181.25	Facility		$134.52	$141.60	$181.25
Sentara Facility/Professional Professional Modifier Low / Median / High Price $134.52 / $141.60 / $181.25	Professional		$134.52	$141.60	$181.25
United Facility/Professional Professional Modifier Low / Median / High Price $139.31 / $141.60 / $171.93	Professional		$139.31	$141.60	$171.93