Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $248.52 / $494.17	Facility		$216.90	$248.52	$494.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $238.59	Professional		$216.90	$216.90	$238.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $448.98 / $709.26	Facility		$216.90	$448.98	$709.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $290.73	Professional		$216.90	$216.90	$290.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $216.74 / $216.74 / $216.91	Professional		$216.74	$216.74	$216.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.63 / $204.63 / $216.90	Facility		$204.63	$204.63	$216.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $216.90	Professional		$216.90	$216.90	$216.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.37 / $216.90 / $260.27	Professional		$184.37	$216.90	$260.27
Medcost Facility/Professional Facility Modifier Low / Median / High Price $178.43 / $227.75 / $347.04	Facility		$178.43	$227.75	$347.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $308.00 / $481.51	Professional		$216.90	$308.00	$481.51
Sentara Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $249.44 / $325.35	Facility		$216.90	$249.44	$325.35
Sentara Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $249.44 / $325.35	Professional		$216.90	$249.44	$325.35
United Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $229.91 / $254.90	Professional		$216.90	$229.91	$254.90