Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,630.83 / $5,412.00 / $19,492.55	Facility		$1,630.83	$5,412.00	$19,492.55
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,871.17 / $7,082.78 / $16,649.41	Facility	50	$4,871.17	$7,082.78	$16,649.41
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $747.24 / $815.42 / $1,942.19	Facility	52	$747.24	$815.42	$1,942.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,162.00 / $17,132.29 / $23,861.81	Facility		$11,162.00	$17,132.29	$23,861.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,379.13 / $1,654.96 / $2,041.11	Professional		$1,379.13	$1,654.96	$2,041.11
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,494.48 / $1,875.23 / $2,734.90	Facility		$1,494.48	$1,875.23	$2,734.90
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $2,579.23 / $3,294.10 / $4,363.20	Facility	50	$2,579.23	$3,294.10	$4,363.20
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $343.90 / $439.21 / $581.76	Facility	80	$343.90	$439.21	$581.76
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $240.73 / $307.45 / $407.23	Facility	AS	$240.73	$307.45	$407.23
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,267.83 / $1,864.78 / $4,283.00	Facility		$1,267.83	$1,864.78	$4,283.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,349.00 / $7,061.00 / $12,739.00	Facility		$4,349.00	$7,061.00	$12,739.00