Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $94.23 / $94.23	Facility		$89.75	$94.23	$94.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $94.23	Professional		$89.75	$89.75	$94.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $119.79	Professional		$89.75	$89.75	$119.79
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $66.23 / $104.60	Professional		$66.23	$66.23	$104.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $84.67 / $89.75	Facility		$84.67	$84.67	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Professional		$89.75	$89.75	$89.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.29 / $89.75 / $1,500.79	Professional		$76.29	$89.75	$1,500.79
Medcost Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $94.23 / $164.24	Facility		$89.75	$94.23	$164.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $84.50 / $107.15 / $176.76	Professional		$84.50	$107.15	$176.76
Sentara Facility/Professional Facility Modifier Low / Median / High Price $60.73 / $72.50 / $113.10	Facility		$60.73	$72.50	$113.10
Sentara Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $72.50 / $113.10	Professional		$60.73	$72.50	$113.10
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $112.64	Professional		$89.75	$89.75	$112.64