Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.10 / $2,516.00 / $8,294.00	Facility		$214.10	$2,516.00	$8,294.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $160.58 / $178.76 / $374.46	Facility	54	$160.58	$178.76	$374.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.39 / $219.21 / $371.81	Professional		$176.39	$219.21	$371.81
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 $180.26 / $233.44 / $385.94	Professional		$180.26	$233.44	$385.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $226.94 / $237.67 / $822.00	Professional		$226.94	$237.67	$822.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $328.64 / $328.64 / $328.64	Facility		$328.64	$328.64	$328.64
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $230.05	Facility	54	$230.05	$230.05	$230.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.05 / $260.52 / $460.00	Professional		$195.05	$260.52	$460.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.82 / $270.79 / $320.02	Professional		$209.82	$270.79	$320.02
Medcost Facility/Professional Facility Modifier Low / Median / High Price $202.59 / $260.00 / $391.74	Facility		$202.59	$260.00	$391.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $268.00 / $297.00 / $434.00	Professional		$268.00	$297.00	$434.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $185.16 / $247.12 / $805.00	Facility		$185.16	$247.12	$805.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $210.41 / $272.43 / $805.00	Professional		$210.41	$272.43	$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 $162.65 / $255.44 / $412.33	Professional		$162.65	$255.44	$412.33