Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $158.49 / $158.49	Facility		$19.05	$158.49	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $229.09	Professional		$112.20	$154.88	$229.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $323.59	Facility		$309.03	$309.03	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $380.19	Professional		$181.97	$181.97	$380.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $208.93	Professional		$162.18	$162.18	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $169.82 / $169.82	Facility		$114.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $169.82	Professional		$125.89	$125.89	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $426.58	Professional		$213.80	$309.03	$426.58
Medcost Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $302.00	Professional		$138.04	$199.53	$302.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $204.17 / $371.54	Facility		$112.20	$204.17	$371.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $169.82 / $199.53	Professional		$165.96	$169.82	$199.53
Sentara Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $251.19 / $891.25	Facility		$165.96	$251.19	$891.25
Sentara Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $891.25	Professional		$165.96	$251.19	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $181.97 / $331.13	Facility		$112.20	$181.97	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $223.87	Professional		$128.82	$151.36	$223.87