Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $386.91 / $3,633.00 / $7,560.00	Facility		$386.91	$3,633.00	$7,560.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.84 / $52.46 / $218.38	Facility	53	$33.84	$52.46	$218.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.81 / $420.40 / $1,138.80	Professional		$149.81	$420.40	$1,138.80
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 $146.88 / $435.41 / $1,145.52	Professional		$146.88	$435.41	$1,145.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $169.73 / $253.76 / $3,026.00	Professional		$169.73	$253.76	$3,026.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.95 / $446.99 / $1,781.18	Professional		$166.95	$446.99	$1,781.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $651.37 / $935.33 / $1,153.57	Professional		$651.37	$935.33	$1,153.57
Medcost Facility/Professional Facility Modifier Low / Median / High Price $169.20 / $779.44 / $1,611.17	Facility		$169.20	$779.44	$1,611.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $349.32 / $1,230.60 / $1,693.00	Professional		$349.32	$1,230.60	$1,693.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $153.82 / $207.66 / $2,039.00	Facility		$153.82	$207.66	$2,039.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $961.73 / $1,259.86 / $2,314.57	Professional		$961.73	$1,259.86	$2,314.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,911.00 / $3,276.00 / $5,340.00	Facility		$1,911.00	$3,276.00	$5,340.00
United Facility/Professional Professional Modifier Low / Median / High Price $829.54 / $1,444.16 / $2,167.29	Professional		$829.54	$1,444.16	$2,167.29