Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $218.78 / $288.40	Facility		$104.71	$218.78	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $125.89	Professional		$104.71	$104.71	$125.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $208.93 / $354.81	Facility		$104.71	$208.93	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $173.78	Professional		$104.71	$104.71	$173.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $263.03 / $389.05	Professional		$229.09	$263.03	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $104.71 / $104.71	Facility		$97.72	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $245.47	Professional		$89.13	$104.71	$245.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Medcost Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $416.87 / $724.44	Facility		$15.14	$416.87	$724.44
Sentara Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $125.89 / $537.03	Facility		$100.00	$125.89	$537.03
Sentara Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $537.03	Professional		$100.00	$125.89	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $169.82 / $812.83	Facility		$104.71	$169.82	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $104.71 / $131.83	Professional		$102.33	$104.71	$131.83