Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $181.97 / $316.23	Facility		$112.20	$181.97	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $114.82 / $316.23	Professional		$112.20	$114.82	$316.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $223.87 / $380.19	Facility		$112.20	$223.87	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $186.21	Professional		$112.20	$112.20	$186.21
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $151.36 / $229.09	Professional		$134.90	$151.36	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $112.20 / $112.20	Facility		$104.71	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $288.40	Professional		$95.50	$112.20	$288.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $257.04 / $489.78	Facility		$112.20	$257.04	$489.78
Sentara Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $162.18 / $478.63	Facility		$104.71	$162.18	$478.63
Sentara Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $478.63	Professional		$104.71	$162.18	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $114.82 / $208.93	Facility		$112.20	$114.82	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $112.20 / $138.04	Professional		$107.15	$112.20	$138.04