Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $116.36 / $231.40	Facility		$102.94	$116.36	$231.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $108.08 / $108.08	Professional		$102.94	$108.08	$108.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.93 / $217.18 / $349.96	Facility		$102.93	$217.18	$349.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $102.94	Professional		$102.94	$102.94	$102.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.11 / $97.11 / $102.94	Facility		$97.11	$97.11	$102.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $102.94	Professional		$102.94	$102.94	$102.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.50 / $123.53 / $192.00	Professional		$87.50	$123.53	$192.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $102.94 / $164.61	Facility		$102.94	$102.94	$164.61
Sentara Facility/Professional Facility Modifier Low / Median / High Price $97.79 / $124.56 / $170.88	Facility		$97.79	$124.56	$170.88
Sentara Facility/Professional Professional Modifier Low / Median / High Price $97.79 / $124.56 / $170.88	Professional		$97.79	$124.56	$170.88
United Facility/Professional Facility Modifier Low / Median / High Price $102.93 / $102.93 / $102.93	Facility		$102.93	$102.93	$102.93
United Facility/Professional Professional Modifier Low / Median / High Price $101.28 / $102.94 / $129.19	Professional		$101.28	$102.94	$129.19