Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $363.08 / $26,915.35	Facility		$173.78	$363.08	$26,915.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $229.09	Professional		$173.78	$173.78	$229.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $323.59 / $588.84	Facility		$173.78	$323.59	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $288.40	Professional		$173.78	$173.78	$288.40
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $269.15	Professional		$173.78	$173.78	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $173.78 / $173.78	Facility		$162.18	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $208.93	Professional		$147.91	$173.78	$208.93
Medcost Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $123.03	Professional		$83.18	$83.18	$123.03
Medcost Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $186.21 / $275.42	Facility		$120.23	$186.21	$275.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $186.21	Professional		$154.88	$186.21	$186.21
Sentara Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $204.17 / $257.04	Facility		$165.96	$204.17	$257.04
Sentara Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $257.04	Professional		$165.96	$204.17	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $173.78 / $269.15	Facility		$165.96	$173.78	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $186.21 / $194.98	Professional		$173.78	$186.21	$194.98