Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.39 / $88.59 / $176.18	Facility		$77.39	$88.59	$176.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $81.26 / $81.26	Professional		$77.39	$81.26	$81.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.39 / $163.29 / $263.13	Facility		$77.39	$163.29	$263.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $77.39 / $77.39	Professional		$77.39	$77.39	$77.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $102.83 / $117.02 / $176.59	Professional		$102.83	$117.02	$176.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.01 / $73.01 / $77.39	Facility		$73.01	$73.01	$77.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $77.39 / $77.39	Professional		$77.39	$77.39	$77.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.78 / $90.32 / $92.87	Professional		$65.78	$90.32	$92.87
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.33 / $77.04 / $126.72	Facility		$30.33	$77.04	$126.72
Sentara Facility/Professional Facility Modifier Low / Median / High Price $72.34 / $77.39 / $99.06	Facility		$72.34	$77.39	$99.06
Sentara Facility/Professional Professional Modifier Low / Median / High Price $72.34 / $77.39 / $99.06	Professional		$72.34	$77.39	$99.06
United Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $77.39 / $90.32	Professional		$77.39	$77.39	$90.32