Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $181.97 / $239.88	Facility		$85.11	$181.97	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $204.17	Professional		$85.11	$87.10	$204.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $162.18 / $295.12	Facility		$87.10	$162.18	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $144.54	Professional		$87.10	$87.10	$144.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $169.82	Professional		$87.10	$87.10	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $87.10 / $87.10	Facility		$81.28	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $691.83	Professional		$74.13	$87.10	$691.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,548.82 / $1,548.82	Professional		$588.84	$1,548.82	$1,548.82
Medcost Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $144.54 / $1,862.09	Facility		$87.10	$144.54	$1,862.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $295.12 / $338.84	Professional		$87.10	$295.12	$338.84
Sentara Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $114.82 / $229.09	Facility		$83.18	$114.82	$229.09
Sentara Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $229.09	Professional		$83.18	$114.82	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $95.50 / $257.04	Facility		$87.10	$95.50	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $158.49	Professional		$87.10	$91.20	$158.49