Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $204.17 / $489.78	Facility		$75.86	$204.17	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $251.19	Professional		$75.86	$97.72	$251.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $204.17	Facility		$190.55	$190.55	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $218.78	Professional		$104.71	$104.71	$218.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $131.83	Professional		$104.71	$104.71	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $107.15 / $107.15	Facility		$81.28	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $107.15	Professional		$77.62	$77.62	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $269.15	Professional		$131.83	$190.55	$269.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $186.21	Professional		$95.50	$125.89	$186.21
Medcost Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $123.03 / $223.87	Facility		$75.86	$123.03	$223.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $239.88	Professional		$87.10	$102.33	$239.88
Sentara Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $154.88 / $549.54	Facility		$102.33	$154.88	$549.54
Sentara Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $549.54	Professional		$102.33	$154.88	$549.54
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $85.11 / $275.42	Facility		$57.54	$85.11	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $93.33 / $147.91	Professional		$83.18	$93.33	$147.91