Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.13 / $93.17 / $93.17	Facility		$77.13	$93.17	$93.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.13 / $93.17 / $103.70	Professional		$77.13	$93.17	$103.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.45 / $188.45 / $200.13	Facility		$188.45	$188.45	$200.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.01 / $101.01 / $134.19	Professional		$101.01	$101.01	$134.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $99.01 / $99.01 / $128.82	Professional		$99.01	$99.01	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.50 / $107.78 / $107.78	Facility		$12.50	$107.78	$107.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $78.68 / $107.78	Professional		$78.68	$78.68	$107.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.91 / $169.61 / $226.14	Professional		$131.91	$169.61	$226.14
Medcost Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $109.01 / $211.44	Facility		$55.55	$109.01	$211.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $235.56 / $313.89	Professional		$112.00	$235.56	$313.89
Sentara Facility/Professional Facility Modifier Low / Median / High Price $72.28 / $141.62 / $235.96	Facility		$72.28	$141.62	$235.96
Sentara Facility/Professional Professional Modifier Low / Median / High Price $72.28 / $141.62 / $235.96	Professional		$72.28	$141.62	$235.96
United Facility/Professional Facility Modifier Low / Median / High Price $64.81 / $85.28 / $99.63	Facility		$64.81	$85.28	$99.63
United Facility/Professional Professional Modifier Low / Median / High Price $78.14 / $94.01 / $141.62	Professional		$78.14	$94.01	$141.62