Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $75.86 / $199.53	Facility		$63.10	$75.86	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $141.25	Professional		$63.10	$77.62	$141.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $169.82	Facility		$158.49	$158.49	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $181.97	Professional		$87.10	$87.10	$181.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $109.65	Professional		$87.10	$87.10	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $89.13 / $89.13	Facility		$69.18	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $89.13	Professional		$64.57	$64.57	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $223.87	Professional		$112.20	$158.49	$223.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $154.88	Professional		$79.43	$104.71	$154.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $107.15 / $194.98	Facility		$63.10	$107.15	$194.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $95.50 / $199.53	Professional		$85.11	$95.50	$199.53
Sentara Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $128.82 / $457.09	Facility		$89.13	$128.82	$457.09
Sentara Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $128.82 / $457.09	Professional		$89.13	$128.82	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $70.79 / $229.09	Facility		$47.86	$70.79	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $125.89	Professional		$70.79	$77.62	$125.89