Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $239.88 / $645.65	Facility		$104.71	$239.88	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $302.00	Professional		$104.71	$109.65	$302.00
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 / $177.83	Professional		$104.71	$104.71	$177.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $269.15	Professional		$154.88	$177.83	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $104.71 / $104.71	Facility		$100.00	$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 / $436.52	Professional		$89.13	$104.71	$436.52
Medcost Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $263.03 / $371.54	Facility		$89.13	$263.03	$371.54
Sentara Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $154.88 / $363.08	Facility		$100.00	$154.88	$363.08
Sentara Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $363.08	Professional		$100.00	$154.88	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $112.20 / $213.80	Facility		$104.71	$112.20	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $104.71 / $131.83	Professional		$102.33	$104.71	$131.83