Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $234.42 / $2,041.74	Facility		$104.71	$234.42	$2,041.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $190.55	Professional		$104.71	$104.71	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $194.98 / $354.81	Facility		$104.71	$194.98	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $173.78	Professional		$104.71	$104.71	$173.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $169.82	Professional		$104.71	$104.71	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $104.71 / $104.71	Facility		$97.72	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $380.19	Professional		$89.13	$104.71	$380.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34
Medcost Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $138.04 / $467.74	Facility		$104.71	$138.04	$467.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $323.59 / $407.38	Professional		$165.96	$323.59	$407.38
Sentara Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $134.90 / $181.97	Facility		$97.72	$134.90	$181.97
Sentara Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $181.97	Professional		$97.72	$134.90	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $109.65 / $245.47	Facility		$104.71	$109.65	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $151.36	Professional		$104.71	$109.65	$151.36