Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $484.50 / $1,346.00 / $5,412.00	Facility		$484.50	$1,346.00	$5,412.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $364.86 / $407.95 / $860.15	Facility	54	$364.86	$407.95	$860.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.77 / $531.14 / $873.60	Professional		$420.77	$531.14	$873.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,060.00 / $3,693.00 / $4,290.00	Facility		$3,060.00	$3,693.00	$4,290.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $418.88 / $535.66 / $885.60	Professional		$418.88	$535.66	$885.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $479.81 / $513.03 / $2,012.00	Professional		$479.81	$513.03	$2,012.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $420.00 / $420.00 / $761.30	Facility		$420.00	$420.00	$761.30
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $532.91 / $532.91 / $532.91	Facility	54	$532.91	$532.91	$532.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.88 / $601.09 / $1,064.93	Professional		$446.88	$601.09	$1,064.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $486.23 / $626.54 / $740.45	Professional		$486.23	$626.54	$740.45
Medcost Facility/Professional Facility Modifier Low / Median / High Price $470.41 / $602.96 / $890.26	Facility		$470.41	$602.96	$890.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $598.00 / $683.00 / $959.00	Professional		$598.00	$683.00	$959.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $433.71 / $574.80 / $1,291.00	Facility		$433.71	$574.80	$1,291.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $487.83 / $635.16 / $1,291.00	Professional		$487.83	$635.16	$1,291.00
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 $384.67 / $604.48 / $947.37	Professional		$384.67	$604.48	$947.37