Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.81 / $159.02 / $237.19	Facility		$93.81	$159.02	$237.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $90.24 / $126.54	Professional		$89.34	$90.24	$126.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $184.93 / $292.14	Facility		$89.34	$184.93	$292.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $119.96	Professional		$89.34	$89.34	$119.96
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.35 / $104.58 / $104.58	Professional		$89.35	$104.58	$104.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.29 / $84.29 / $89.34	Facility		$84.29	$84.29	$89.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $89.34	Professional		$89.34	$89.34	$89.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.94 / $89.34 / $139.44	Professional		$75.94	$89.34	$139.44
Medcost Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $123.29 / $181.96	Facility		$89.34	$123.29	$181.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $133.13 / $180.00 / $254.00	Professional		$133.13	$180.00	$254.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $107.21 / $154.19	Facility		$89.34	$107.21	$154.19
Sentara Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $107.21 / $154.19	Professional		$89.34	$107.21	$154.19
United Facility/Professional Facility Modifier Low / Median / High Price $118.75 / $118.75 / $118.75	Facility		$118.75	$118.75	$118.75
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $94.70 / $106.31	Professional		$89.34	$94.70	$106.31