Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.13 / $2,516.00 / $8,294.00	Facility		$235.13	$2,516.00	$8,294.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $176.35 / $199.80 / $411.57	Facility	54	$176.35	$199.80	$411.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.06 / $246.17 / $430.20	Professional		$201.06	$246.17	$430.20
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 $196.92 / $257.42 / $425.59	Professional		$196.92	$257.42	$425.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $245.79 / $262.11 / $822.00	Professional		$245.79	$262.11	$822.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $362.57 / $362.57 / $362.57	Facility		$362.57	$362.57	$362.57
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $253.80	Facility	54	$253.80	$253.80	$253.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.18 / $288.43 / $521.48	Professional		$214.18	$288.43	$521.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.98 / $307.98 / $363.97	Professional		$237.98	$307.98	$363.97
Medcost Facility/Professional Facility Modifier Low / Median / High Price $223.45 / $286.13 / $435.20	Facility		$223.45	$286.13	$435.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $293.00 / $328.00 / $473.00	Professional		$293.00	$328.00	$473.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $200.91 / $269.45 / $805.00	Facility		$200.91	$269.45	$805.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $232.19 / $301.86 / $819.00	Professional		$232.19	$301.86	$819.00
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 $179.10 / $287.75 / $463.98	Professional		$179.10	$287.75	$463.98