Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $131.83 / $131.83	Facility		$128.82	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $194.98	Professional		$95.50	$128.82	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $269.15	Facility		$251.19	$251.19	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $288.40	Professional		$138.04	$138.04	$288.40
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $173.78	Professional		$131.83	$131.83	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $173.78 / $173.78	Facility		$109.65	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $173.78	Professional		$128.82	$128.82	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $354.81	Professional		$177.83	$251.19	$354.81
Medcost Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $245.47	Professional		$117.49	$165.96	$245.47
Medcost Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $165.96 / $309.03	Facility		$95.50	$165.96	$309.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $134.90 / $162.18	Professional		$131.83	$134.90	$162.18
Sentara Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $204.17 / $724.44	Facility		$134.90	$204.17	$724.44
Sentara Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $724.44	Professional		$134.90	$204.17	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $158.49 / $281.84	Facility		$79.43	$158.49	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $186.21	Professional		$107.15	$123.03	$186.21