Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $496.74 / $569.29 / $1,132.04	Facility		$496.74	$569.29	$1,132.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $521.58 / $521.58	Professional		$496.74	$521.58	$521.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $496.74 / $1,048.11 / $1,688.92	Facility		$496.74	$1,048.11	$1,688.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $496.74	Professional		$496.74	$496.74	$496.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $672.21 / $764.92 / $1,154.33	Professional		$672.21	$764.92	$1,154.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.62 / $468.62 / $496.74	Facility		$468.62	$468.62	$496.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $496.74	Professional		$496.74	$496.74	$496.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $422.23 / $567.88 / $596.09	Professional		$422.23	$567.88	$596.09
Medcost Facility/Professional Facility Modifier Low / Median / High Price $496.74 / $496.74 / $794.37	Facility		$496.74	$496.74	$794.37
Sentara Facility/Professional Facility Modifier Low / Median / High Price $462.91 / $481.84 / $635.83	Facility		$462.91	$481.84	$635.83
Sentara Facility/Professional Professional Modifier Low / Median / High Price $462.91 / $481.84 / $635.83	Professional		$462.91	$481.84	$635.83
United Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $596.09	Professional		$496.74	$496.74	$596.09