Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.59 / $664.76 / $5,042.39	Facility		$138.59	$664.76	$5,042.39
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $80.98 / $97.82 / $193.38	Facility	54	$80.98	$97.82	$193.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.34 / $130.43 / $226.28	Professional		$93.34	$130.43	$226.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,735.00 / $2,390.00 / $2,954.00	Facility		$1,735.00	$2,390.00	$2,954.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.18 / $134.91 / $189.98	Professional		$102.18	$134.91	$189.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $108.53 / $108.53 / $974.00	Professional		$108.53	$108.53	$974.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.33 / $178.33 / $178.33	Facility		$178.33	$178.33	$178.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $124.83 / $124.83 / $124.83	Facility	54	$124.83	$124.83	$124.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.38 / $131.66 / $247.34	Professional		$104.38	$131.66	$247.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.16 / $149.76 / $178.29	Professional		$134.16	$149.76	$178.29
Medcost Facility/Professional Facility Modifier Low / Median / High Price $95.74 / $126.00 / $172.92	Facility		$95.74	$126.00	$172.92
Medcost Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $157.00 / $252.50	Professional		$136.00	$157.00	$252.50
Sentara Facility/Professional Facility Modifier Low / Median / High Price $92.59 / $124.68 / $1,082.00	Facility		$92.59	$124.68	$1,082.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $148.88 / $1,082.00	Professional		$104.40	$148.88	$1,082.00
United Facility/Professional Facility Modifier Low / Median / High Price $206.00 / $819.00 / $2,364.00	Facility		$206.00	$819.00	$2,364.00
United Facility/Professional Professional Modifier Low / Median / High Price $86.11 / $123.01 / $214.04	Professional		$86.11	$123.01	$214.04