Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.21 / $693.78 / $5,636.00	Facility		$219.21	$693.78	$5,636.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $139.97 / $164.42 / $356.73	Facility	54	$139.97	$164.42	$356.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $157.25 / $216.63 / $387.00	Professional		$157.25	$216.63	$387.00
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 $175.32 / $228.84 / $327.79	Professional		$175.32	$228.84	$327.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $263.16 / $343.26 / $491.69	Professional	50	$263.16	$343.26	$491.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $200.96 / $200.96 / $974.00	Professional		$200.96	$200.96	$974.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $308.79 / $308.79 / $308.79	Facility		$308.79	$308.79	$308.79
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $216.15 / $216.15 / $216.15	Facility	54	$216.15	$216.15	$216.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.82 / $227.88 / $419.80	Professional		$180.82	$227.88	$419.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $224.60 / $249.25 / $296.73	Professional		$224.60	$249.25	$296.73
Medcost Facility/Professional Facility Modifier Low / Median / High Price $170.86 / $219.43 / $307.13	Facility		$170.86	$219.43	$307.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $239.00 / $274.00 / $434.76	Professional		$239.00	$274.00	$434.76
Sentara Facility/Professional Facility Modifier Low / Median / High Price $172.55 / $225.24 / $1,082.00	Facility		$172.55	$225.24	$1,082.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $183.77 / $255.24 / $1,082.00	Professional		$183.77	$255.24	$1,082.00
United Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $1,045.00 / $2,364.00	Facility		$296.00	$1,045.00	$2,364.00
United Facility/Professional Professional Modifier Low / Median / High Price $143.35 / $211.23 / $372.92	Professional		$143.35	$211.23	$372.92