Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $89.93 / $178.82	Facility		$78.93	$89.93	$178.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $82.88 / $87.69	Professional		$78.93	$82.88	$87.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $166.54 / $268.36	Facility		$78.93	$166.54	$268.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $78.93	Professional		$78.93	$78.93	$78.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $110.10 / $125.28 / $189.07	Professional		$110.10	$125.28	$189.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.47 / $74.47 / $78.93	Facility		$74.47	$74.47	$78.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $78.93 / $78.93	Professional		$78.93	$78.93	$78.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $94.72 / $96.00	Professional		$67.09	$94.72	$96.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $78.93 / $126.23	Facility		$78.93	$78.93	$126.23
Sentara Facility/Professional Facility Modifier Low / Median / High Price $74.98 / $78.93 / $101.03	Facility		$74.98	$78.93	$101.03
Sentara Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $78.93 / $101.03	Professional		$74.98	$78.93	$101.03
United Facility/Professional Facility Modifier Low / Median / High Price $303.01 / $303.01 / $303.01	Facility		$303.01	$303.01	$303.01
United Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $78.93 / $96.00	Professional		$76.56	$78.93	$96.00