Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $117.49	Facility		$112.20	$112.20	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $575.44	Professional		$112.20	$112.20	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $1,318.26	Professional		$776.25	$776.25	$1,318.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $407.38 / $407.38	Professional		$199.53	$407.38	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $112.20	Facility		$107.15	$107.15	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $977.24	Professional		$120.23	$173.78	$977.24
Medcost Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $125.89 / $977.24	Facility		$112.20	$125.89	$977.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $112.20 / $933.25	Professional		$109.65	$112.20	$933.25
Sentara Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $588.84 / $1,380.38	Facility		$436.52	$588.84	$1,380.38
Sentara Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $588.84 / $1,380.38	Professional		$436.52	$588.84	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $812.83	Professional		$125.89	$177.83	$812.83