Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $95.00 / $188.92	Facility		$81.90	$95.00	$188.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $82.72 / $91.35	Professional		$81.90	$82.72	$91.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $169.53 / $267.81	Facility		$81.90	$169.53	$267.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $109.77	Professional		$81.90	$81.90	$109.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $82.86 / $82.86	Professional		$81.90	$82.86	$82.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $77.26 / $81.90	Facility		$77.26	$77.26	$81.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $81.90	Professional		$81.90	$81.90	$81.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.62 / $81.90 / $104.39	Professional		$69.62	$81.90	$104.39
Medcost Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $86.00 / $131.58	Facility		$71.95	$86.00	$131.58
Medcost Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $115.00 / $183.60	Professional		$66.37	$115.00	$183.60
Sentara Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $96.09 / $122.85	Facility		$81.90	$96.09	$122.85
Sentara Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $96.09 / $122.85	Professional		$81.90	$96.09	$122.85
United Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $86.81 / $94.02	Professional		$81.90	$86.81	$94.02