Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $370.89 / $2,095.87 / $6,042.00	Facility		$370.89	$2,095.87	$6,042.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $101.44 / $200.33 / $346.47	Facility	52	$101.44	$200.33	$346.47
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.21 / $80.13 / $118.20	Facility	53	$40.21	$80.13	$118.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.46 / $341.75 / $625.02	Professional		$183.46	$341.75	$625.02
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 $174.37 / $339.17 / $549.33	Professional		$174.37	$339.17	$549.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $192.35 / $195.87 / $399.57	Professional		$192.35	$195.87	$399.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $511.22 / $875.00	Facility		$296.61	$511.22	$875.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.17 / $330.00 / $678.94	Professional		$189.17	$330.00	$678.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.86 / $444.11 / $578.70	Professional		$338.86	$444.11	$578.70
Medcost Facility/Professional Facility Modifier Low / Median / High Price $201.03 / $340.56 / $647.54	Facility		$201.03	$340.56	$647.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $257.77 / $432.00 / $713.00	Professional		$257.77	$432.00	$713.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $189.77 / $244.61 / $424.23	Facility		$189.77	$244.61	$424.23
Sentara Facility/Professional Professional Modifier Low / Median / High Price $233.43 / $478.51 / $877.90	Professional		$233.43	$478.51	$877.90
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 $193.09 / $357.78 / $697.81	Professional		$193.09	$357.78	$697.81