Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $215.20 / $565.67	Facility		$204.96	$215.20	$565.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $215.20	Professional		$204.96	$204.96	$215.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $274.72	Professional		$204.96	$204.96	$274.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $620.16 / $620.16 / $620.16	Professional		$620.16	$620.16	$620.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.35 / $193.35 / $204.96	Facility		$193.35	$193.35	$204.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $204.96	Professional		$204.96	$204.96	$204.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.22 / $204.96 / $1,139.94	Professional		$174.22	$204.96	$1,139.94
Medcost Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $215.20 / $758.77	Facility		$204.96	$215.20	$758.77
Medcost Facility/Professional Professional Modifier Low / Median / High Price $359.66 / $805.88 / $1,167.00	Professional		$359.66	$805.88	$1,167.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,055.56 / $1,203.33 / $1,583.34	Facility		$1,055.56	$1,203.33	$1,583.34
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,055.56 / $1,203.33 / $1,583.34	Professional		$1,055.56	$1,203.33	$1,583.34
United Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $257.22	Professional		$204.96	$204.96	$257.22