Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $236.88 / $2,442.00 / $7,275.00	Facility		$236.88	$2,442.00	$7,275.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $114.02 / $114.67 / $274.05	Facility	52	$114.02	$114.67	$274.05
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $45.61 / $45.87 / $109.62	Facility	53	$45.61	$45.87	$109.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,060.00 / $3,693.00 / $4,290.00	Facility		$3,060.00	$3,693.00	$4,290.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.67 / $789.83 / $1,140.85	Facility		$225.67	$789.83	$1,140.85
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $187.06 / $233.83 / $446.00	Professional		$187.06	$233.83	$446.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $213.06 / $306.95 / $461.25	Facility		$213.06	$306.95	$461.25
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $64.08 / $76.80 / $118.46	Facility	80	$64.08	$76.80	$118.46
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $39.81 / $49.36 / $82.92	Facility	AS	$39.81	$49.36	$82.92
Sentara Facility/Professional Facility Modifier Low / Median / High Price $223.59 / $298.58 / $480.95	Facility		$223.59	$298.58	$480.95
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