Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $169.71 / $169.71	Facility		$161.62	$169.71	$169.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $169.71	Professional		$161.62	$161.62	$169.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $215.73	Professional		$161.62	$161.62	$215.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $164.16 / $164.16 / $164.16	Professional		$164.16	$164.16	$164.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.47 / $152.47 / $161.62	Facility		$152.47	$152.47	$161.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $161.62	Professional		$161.62	$161.62	$161.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $161.62 / $210.11	Professional		$137.38	$161.62	$210.11
Medcost Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $169.71 / $273.14	Facility		$161.62	$169.71	$273.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $302.00 / $302.00	Professional		$161.62	$302.00	$302.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $262.14 / $282.83 / $413.91	Facility		$262.14	$282.83	$413.91
Sentara Facility/Professional Professional Modifier Low / Median / High Price $262.14 / $282.83 / $413.91	Professional		$262.14	$282.83	$413.91
United Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $246.85	Professional		$161.62	$161.62	$246.85