Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.19 / $16.87 / $33.56	Facility		$4.19	$16.87	$33.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.23 / $15.91	Professional		$4.19	$4.23	$15.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.19 / $8.67 / $13.70	Facility		$4.19	$8.67	$13.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.19 / $6.38	Professional		$4.19	$4.19	$6.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $14.71 / $14.71	Professional		$4.19	$14.71	$14.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.95 / $3.95 / $4.19	Facility		$3.95	$3.95	$4.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.19 / $4.19	Professional		$4.19	$4.19	$4.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3.56 / $4.19 / $125.34	Professional		$3.56	$4.19	$125.34
Medcost Facility/Professional Facility Modifier Low / Median / High Price $4.19 / $5.99 / $141.75	Facility		$4.19	$5.99	$141.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $98.00 / $335.00	Professional		$21.39	$98.00	$335.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $4.19 / $5.03 / $114.00	Facility		$4.19	$5.03	$114.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $5.03 / $114.00	Professional		$4.19	$5.03	$114.00
United Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.44 / $4.99	Professional		$4.19	$4.44	$4.99