Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.99 / $1,346.00 / $6,827.70	Facility		$59.99	$1,346.00	$6,827.70
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $195.51 / $195.51 / $195.51	Facility	50	$195.51	$195.51	$195.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.49 / $82.49 / $144.07	Professional		$50.49	$82.49	$144.07
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 $51.11 / $84.56 / $137.41	Professional		$51.11	$84.56	$137.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $76.66 / $126.84 / $208.15	Professional	50	$76.66	$126.84	$208.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.75 / $62.27 / $1,757.00	Professional		$59.75	$62.27	$1,757.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.02 / $89.02 / $640.00	Facility		$89.02	$89.02	$640.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $90.89 / $158.77	Professional		$54.75	$90.89	$158.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.56 / $109.60 / $129.53	Professional		$85.56	$109.60	$129.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $59.05 / $91.09 / $142.99	Facility		$59.05	$91.09	$142.99
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $160.28 / $185.12 / $333.54	Facility	50	$160.28	$185.12	$333.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $114.00 / $168.00	Professional		$99.00	$114.00	$168.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $52.15 / $70.91 / $780.00	Facility		$52.15	$70.91	$780.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $110.31 / $780.00	Professional		$85.59	$110.31	$780.00
United Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $1,890.00 / $3,765.00	Facility		$921.00	$1,890.00	$3,765.00
United Facility/Professional Professional Modifier Low / Median / High Price $68.67 / $106.95 / $158.41	Professional		$68.67	$106.95	$158.41