Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $3,162.28	Facility		$123.03	$123.03	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $269.15	Professional		$123.03	$123.03	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $363.08	Professional		$213.80	$213.80	$363.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $223.87 / $223.87	Professional		$194.98	$223.87	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $123.03	Facility		$117.49	$117.49	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $281.84	Professional		$120.23	$173.78	$281.84
Medcost Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $138.04 / $269.15	Facility		$123.03	$138.04	$269.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $123.03 / $257.04	Professional		$109.65	$123.03	$257.04
Sentara Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $257.04 / $331.13	Facility		$213.80	$257.04	$331.13
Sentara Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $331.13	Professional		$213.80	$257.04	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $134.90 / $223.87	Professional		$125.89	$134.90	$223.87