Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.21 / $159.01 / $316.17	Facility		$139.21	$159.01	$316.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $167.79	Professional		$139.21	$139.21	$167.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.21 / $288.16 / $455.22	Facility		$139.21	$288.16	$455.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $186.59	Professional		$139.21	$139.21	$186.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $138.66 / $138.66 / $139.21	Professional		$138.66	$138.66	$139.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.33 / $131.33 / $139.21	Facility		$131.33	$131.33	$139.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $139.21	Professional		$139.21	$139.21	$139.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $139.21 / $167.05	Professional		$118.33	$139.21	$167.05
Medcost Facility/Professional Facility Modifier Low / Median / High Price $63.74 / $139.34 / $217.57	Facility		$63.74	$139.34	$217.57
Medcost Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $152.15 / $207.64	Professional		$96.00	$152.15	$207.64
Sentara Facility/Professional Facility Modifier Low / Median / High Price $139.21 / $160.09 / $208.82	Facility		$139.21	$160.09	$208.82
Sentara Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $160.09 / $208.82	Professional		$139.21	$160.09	$208.82
United Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $147.56 / $159.81	Professional		$139.21	$147.56	$159.81