Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $371.54 / $1,148.15	Facility		$93.33	$371.54	$1,148.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $112.20	Professional		$93.33	$93.33	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $186.21 / $316.23	Facility		$93.33	$186.21	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $158.49	Professional		$93.33	$93.33	$158.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $147.91 / $218.78	Professional		$128.82	$147.91	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $93.33 / $93.33	Facility		$89.13	$93.33	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $112.20	Professional		$79.43	$93.33	$112.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Medcost Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $97.72 / $158.49	Facility		$40.74	$97.72	$158.49
Sentara Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $100.00 / $138.04	Facility		$89.13	$100.00	$138.04
Sentara Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $138.04	Professional		$89.13	$100.00	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $93.33 / $151.36	Facility		$91.20	$93.33	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $93.33 / $112.20	Professional		$91.20	$93.33	$112.20