Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $741.31 / $5,888.44	Facility		$58.88	$741.31	$5,888.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,786.30 / $4,786.30 / $6,025.60	Facility	50	$4,786.30	$4,786.30	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $67.61 / $169.82	Professional		$30.20	$67.61	$169.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,570.40 / $2,951.21	Facility		$2,137.96	$2,570.40	$2,951.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $74.13 / $141.25	Professional		$33.88	$74.13	$141.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $1,047.13	Professional		$30.20	$42.66	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $61.66 / $158.49	Professional		$35.48	$61.66	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $120.23	Professional		$79.43	$95.50	$120.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $194.98	Professional		$51.29	$64.57	$194.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $63.10 / $134.90	Facility		$33.88	$63.10	$134.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
Sentara Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $48.98 / $1,174.90	Facility		$30.20	$48.98	$1,174.90
Sentara Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $85.11 / $1,174.90	Professional		$41.69	$85.11	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,148.15 / $2,398.83	Facility		$218.78	$1,148.15	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $60.26 / $141.25	Professional		$30.90	$60.26	$141.25