Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.55 / $1,938.00 / $8,294.00	Facility		$207.55	$1,938.00	$8,294.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $154.31 / $164.87 / $359.00	Facility	54	$154.31	$164.87	$359.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.88 / $219.82 / $384.91	Professional		$165.88	$219.82	$384.91
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $127.19 / $155.32 / $193.38	Professional	54	$127.19	$155.32	$193.38
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 $179.48 / $234.62 / $387.89	Professional		$179.48	$234.62	$387.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $240.12 / $822.00	Professional		$217.46	$240.12	$822.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.43 / $329.43 / $329.43	Facility		$329.43	$329.43	$329.43
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.60 / $230.60 / $230.60	Facility	54	$230.60	$230.60	$230.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.87 / $239.84 / $446.64	Professional		$183.87	$239.84	$446.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.30 / $264.39 / $312.45	Professional		$204.30	$264.39	$312.45
Medcost Facility/Professional Facility Modifier Low / Median / High Price $186.81 / $240.72 / $373.69	Facility		$186.81	$240.72	$373.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $242.00 / $272.00 / $395.00	Professional		$242.00	$272.00	$395.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $165.05 / $231.87 / $805.00	Facility		$165.05	$231.87	$805.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $181.86 / $248.46 / $805.00	Professional		$181.86	$248.46	$805.00
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 $146.33 / $229.88 / $373.67	Professional		$146.33	$229.88	$373.67