Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $95.50 / $213.80	Facility		$77.62	$95.50	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $169.82	Professional		$77.62	$107.15	$169.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $208.93	Facility		$194.98	$194.98	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $251.19	Professional		$120.23	$120.23	$251.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $134.90	Professional		$102.33	$102.33	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $138.04 / $138.04	Facility		$91.20	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $138.04	Professional		$100.00	$100.00	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $275.42	Professional		$138.04	$194.98	$275.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $194.98	Professional		$128.82	$128.82	$194.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $138.04 / $263.03	Facility		$79.43	$138.04	$263.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $245.47	Professional		$104.71	$114.82	$245.47
Sentara Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $162.18 / $562.34	Facility		$104.71	$162.18	$562.34
Sentara Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $562.34	Professional		$104.71	$162.18	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $95.50 / $263.03	Facility		$64.57	$95.50	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $95.50 / $154.88	Professional		$87.10	$95.50	$154.88