Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $162.18 / $213.80	Facility		$77.62	$162.18	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $85.11	Professional		$77.62	$77.62	$85.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $154.88 / $263.03	Facility		$77.62	$154.88	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $128.82	Professional		$77.62	$77.62	$128.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $123.03 / $186.21	Professional		$109.65	$123.03	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $77.62 / $77.62	Facility		$72.44	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $93.33	Professional		$66.07	$77.62	$93.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $107.15	Facility		$77.62	$77.62	$107.15
Sentara Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $77.62 / $114.82	Facility		$74.13	$77.62	$114.82
Sentara Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $114.82	Professional		$74.13	$77.62	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $125.89	Facility		$77.62	$77.62	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $77.62 / $91.20	Professional		$75.86	$77.62	$91.20