Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.67 / $1,822.50 / $7,036.31	Facility		$322.67	$1,822.50	$7,036.31
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $87.44 / $255.95 / $678.89	Facility	52	$87.44	$255.95	$678.89
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.97 / $102.38 / $271.55	Facility	53	$34.97	$102.38	$271.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.72 / $310.52 / $1,785.90	Professional		$151.72	$310.52	$1,785.90
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
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.65 / $402.42 / $1,531.83	Professional		$151.65	$402.42	$1,531.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $167.45 / $169.90 / $348.29	Professional		$167.45	$169.90	$348.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.77 / $789.83 / $1,140.85	Facility		$257.77	$789.83	$1,140.85
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.52 / $300.00 / $1,908.64	Professional		$164.52	$300.00	$1,908.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $525.00 / $1,169.46 / $1,725.01	Professional		$525.00	$1,169.46	$1,725.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $174.87 / $292.32 / $1,832.16	Facility		$174.87	$292.32	$1,832.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $223.65 / $1,253.00 / $2,010.00	Professional		$223.65	$1,253.00	$2,010.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $118.18 / $209.14 / $367.06	Facility		$118.18	$209.14	$367.06
Sentara Facility/Professional Professional Modifier Low / Median / High Price $203.09 / $1,093.73 / $2,516.86	Professional		$203.09	$1,093.73	$2,516.86
United Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $2,774.00 / $5,226.00	Facility		$490.00	$2,774.00	$5,226.00
United Facility/Professional Professional Modifier Low / Median / High Price $167.34 / $1,040.66 / $2,004.24	Professional		$167.34	$1,040.66	$2,004.24