Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.88 / $1,719.00 / $6,827.70	Facility		$179.88	$1,719.00	$6,827.70
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $49.50 / $127.09 / $163.19	Facility	52	$49.50	$127.09	$163.19
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.80 / $50.84 / $65.28	Facility	53	$19.80	$50.84	$65.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.93 / $202.33 / $435.68	Professional		$90.93	$202.33	$435.68
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 $87.52 / $214.03 / $377.70	Professional		$87.52	$214.03	$377.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.16 / $97.96 / $199.84	Professional		$97.16	$97.96	$199.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $509.74 / $617.00	Facility		$147.60	$509.74	$617.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.90 / $225.23 / $443.05	Professional		$99.90	$225.23	$443.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $247.22 / $309.02 / $441.00	Professional		$247.22	$309.02	$441.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $99.00 / $248.34 / $447.15	Facility		$99.00	$248.34	$447.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $258.00 / $305.00 / $490.00	Professional		$258.00	$305.00	$490.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $95.70 / $126.54 / $228.22	Facility		$95.70	$126.54	$228.22
Sentara Facility/Professional Professional Modifier Low / Median / High Price $242.92 / $320.02 / $632.66	Professional		$242.92	$320.02	$632.66
United Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $2,521.00 / $5,226.00	Facility		$490.00	$2,521.00	$5,226.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.89 / $290.20 / $462.31	Professional		$191.89	$290.20	$462.31