Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.11 / $1,938.00 / $8,294.00	Facility		$349.11	$1,938.00	$8,294.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $261.83 / $275.62 / $608.40	Facility	54	$261.83	$275.62	$608.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.36 / $367.49 / $653.16	Professional		$262.36	$367.49	$653.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,038.72 / $1,038.72 / $1,038.72	Professional	50	$1,038.72	$1,038.72	$1,038.72
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $200.57 / $261.83 / $326.23	Professional	54	$200.57	$261.83	$326.23
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 $306.05 / $400.07 / $661.43	Professional		$306.05	$400.07	$661.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $459.08 / $600.10 / $992.15	Professional	50	$459.08	$600.10	$992.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $365.92 / $406.17 / $822.00	Professional		$365.92	$406.17	$822.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $560.70 / $560.70 / $560.70	Facility		$560.70	$560.70	$560.70
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $392.49	Facility	54	$392.49	$392.49	$392.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.08 / $388.50 / $750.39	Professional		$295.08	$388.50	$750.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $342.30 / $442.97 / $523.51	Professional		$342.30	$442.97	$523.51
Medcost Facility/Professional Facility Modifier Low / Median / High Price $315.85 / $403.15 / $622.46	Facility		$315.85	$403.15	$622.46
Medcost Facility/Professional Professional Modifier Low / Median / High Price $382.00 / $435.00 / $658.00	Professional		$382.00	$435.00	$658.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $266.64 / $392.72 / $831.79	Facility		$266.64	$392.72	$831.79
Sentara Facility/Professional Professional Modifier Low / Median / High Price $282.25 / $412.27 / $870.88	Professional		$282.25	$412.27	$870.88
United Facility/Professional Facility Modifier Low / Median / High Price $231.00 / $1,045.00 / $2,364.00	Facility		$231.00	$1,045.00	$2,364.00
United Facility/Professional Professional Modifier Low / Median / High Price $230.77 / $373.31 / $629.52	Professional		$230.77	$373.31	$629.52