Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.65 / $285.70 / $3,613.20	Facility		$111.65	$285.70	$3,613.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $107.40 / $164.61	Professional		$106.33	$107.40	$164.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $220.10 / $347.70	Facility		$106.33	$220.10	$347.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $142.77	Professional		$106.33	$106.33	$142.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $107.36 / $140.69 / $140.69	Professional		$107.36	$140.69	$140.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.32 / $100.32 / $106.33	Facility		$100.32	$100.32	$106.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $106.33	Professional		$106.33	$106.33	$106.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.38 / $106.33 / $375.75	Professional		$90.38	$106.33	$375.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $118.35 / $396.63	Facility		$106.33	$118.35	$396.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $122.10 / $240.91 / $609.00	Professional		$122.10	$240.91	$609.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $127.60 / $417.50	Facility		$106.33	$127.60	$417.50
Sentara Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $127.60 / $417.50	Professional		$106.33	$127.60	$417.50
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $112.71 / $125.58	Professional		$106.33	$112.71	$125.58