Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.48 / $368.69 / $467.49	Facility		$217.48	$368.69	$467.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $248.89	Professional		$207.13	$207.13	$248.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $428.76 / $677.32	Facility		$207.13	$428.76	$677.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $277.63	Professional		$207.13	$207.13	$277.63
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $206.13 / $206.13 / $207.12	Professional		$206.13	$206.13	$207.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.40 / $195.40 / $207.13	Facility		$195.40	$195.40	$207.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $207.13	Professional		$207.13	$207.13	$207.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $176.06 / $207.13 / $248.56	Professional		$176.06	$207.13	$248.56
Medcost Facility/Professional Facility Modifier Low / Median / High Price $173.25 / $217.48 / $334.13	Facility		$173.25	$217.48	$334.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $308.00 / $480.02	Professional		$207.13	$308.00	$480.02
Sentara Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $238.20 / $310.70	Facility		$207.13	$238.20	$310.70
Sentara Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $238.20 / $310.70	Professional		$207.13	$238.20	$310.70
United Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $219.56 / $244.41	Professional		$207.13	$219.56	$244.41