Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.74 / $1,419.11 / $5,743.00	Facility		$302.74	$1,419.11	$5,743.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $62.41 / $166.66 / $196.76	Facility	52	$62.41	$166.66	$196.76
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.96 / $66.66 / $78.70	Facility	53	$24.96	$66.66	$78.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.89 / $251.29 / $614.79	Professional		$114.89	$251.29	$614.79
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 $105.60 / $253.54 / $425.37	Professional		$105.60	$253.54	$425.37
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $121.85 / $179.78 / $2,413.00	Professional		$121.85	$179.78	$2,413.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.50 / $300.23 / $847.96	Professional		$122.50	$300.23	$847.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $292.27 / $350.72 / $432.56	Professional		$292.27	$350.72	$432.56
Medcost Facility/Professional Facility Modifier Low / Median / High Price $126.54 / $316.50 / $720.12	Facility		$126.54	$316.50	$720.12
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $292.45 / $887.45 / $1,434.67	Facility	50	$292.45	$887.45	$1,434.67
Medcost Facility/Professional Professional Modifier Low / Median / High Price $344.62 / $411.00 / $705.00	Professional		$344.62	$411.00	$705.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $114.72 / $150.47 / $1,428.00	Facility		$114.72	$150.47	$1,428.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $320.50 / $588.54 / $1,428.00	Professional		$320.50	$588.54	$1,428.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,066.00 / $1,893.00 / $3,765.00	Facility		$1,066.00	$1,893.00	$3,765.00
United Facility/Professional Professional Modifier Low / Median / High Price $258.20 / $495.22 / $980.06	Professional		$258.20	$495.22	$980.06