Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $522.57 / $5,087.00 / $21,562.00	Facility		$522.57	$5,087.00	$21,562.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $7,213.50 / $7,213.50 / $7,213.50	Facility	50	$7,213.50	$7,213.50	$7,213.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.60 / $3,333.45 / $5,848.10	Professional		$307.60	$3,333.45	$5,848.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26,917.00 / $35,151.00 / $39,057.00	Facility		$26,917.00	$35,151.00	$39,057.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.70 / $1,019.66 / $4,458.79	Professional		$289.70	$1,019.66	$4,458.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $434.57 / $1,529.49 / $6,688.18	Professional	50	$434.57	$1,529.49	$6,688.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $325.81 / $442.14 / $9,638.00	Professional		$325.81	$442.14	$9,638.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.02 / $846.55 / $5,920.45	Professional		$342.02	$846.55	$5,920.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,081.55 / $3,711.97 / $4,639.96	Professional		$3,081.55	$3,711.97	$4,639.96
Medcost Facility/Professional Facility Modifier Low / Median / High Price $360.70 / $3,081.55 / $6,114.46	Facility		$360.70	$3,081.55	$6,114.46
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $800.20 / $8,968.54 / $10,544.82	Facility	50	$800.20	$8,968.54	$10,544.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $4,160.00 / $5,474.00 / $10,213.00	Professional		$4,160.00	$5,474.00	$10,213.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $320.83 / $428.88 / $16,786.00	Facility		$320.83	$428.88	$16,786.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $3,615.79 / $5,241.59 / $16,786.00	Professional		$3,615.79	$5,241.59	$16,786.00
United Facility/Professional Facility Modifier Low / Median / High Price $12,301.00 / $20,974.00 / $40,876.00	Facility		$12,301.00	$20,974.00	$40,876.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,958.84 / $5,236.43 / $7,338.75	Professional		$2,958.84	$5,236.43	$7,338.75