Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $142.15 / $269.95	Facility		$79.86	$142.15	$269.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $87.85	Professional		$79.86	$79.86	$87.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $165.31 / $261.14	Facility		$79.86	$165.31	$261.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $107.23	Professional		$79.86	$79.86	$107.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $63.38 / $79.86	Professional		$63.38	$63.38	$79.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.34 / $75.34 / $79.86	Facility		$75.34	$75.34	$79.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $79.86 / $79.86	Professional		$79.86	$79.86	$79.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.88 / $79.86 / $154.62	Professional		$67.88	$79.86	$154.62
Medcost Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $100.79 / $205.44	Facility		$79.86	$100.79	$205.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $110.98 / $213.00 / $359.00	Professional		$110.98	$213.00	$359.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $95.83 / $158.63	Facility		$79.86	$95.83	$158.63
Sentara Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $95.83 / $158.63	Professional		$79.86	$95.83	$158.63
United Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $84.65 / $95.03	Professional		$79.86	$84.65	$95.03