Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $191.34 / $253.29	Facility		$86.38	$191.34	$253.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.37 / $90.70 / $141.49	Professional		$86.37	$90.70	$141.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $182.26 / $293.69	Facility		$86.38	$182.26	$293.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $188.27 / $214.24 / $323.30	Professional		$188.27	$214.24	$323.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.48 / $81.48 / $86.38	Facility		$81.48	$81.48	$86.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $86.38 / $86.38	Professional		$86.38	$86.38	$86.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $103.66 / $468.47	Professional		$73.42	$103.66	$468.47
Medcost Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $404.07 / $632.85	Facility		$86.38	$404.07	$632.85
Medcost Facility/Professional Professional Modifier Low / Median / High Price $469.00 / $469.00 / $469.00	Professional		$469.00	$469.00	$469.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $82.06 / $104.52 / $416.52	Facility		$82.06	$104.52	$416.52
Sentara Facility/Professional Professional Modifier Low / Median / High Price $82.06 / $104.52 / $416.52	Professional		$82.06	$104.52	$416.52
United Facility/Professional Professional Modifier Low / Median / High Price $83.79 / $86.38 / $108.41	Professional		$83.79	$86.38	$108.41