Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.71 / $1,792.00 / $8,294.00	Facility		$97.71	$1,792.00	$8,294.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $31.91 / $92.24 / $115.24	Facility	52	$31.91	$92.24	$115.24
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.76 / $36.89 / $46.09	Facility	53	$12.76	$36.89	$46.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.33 / $127.67 / $292.30	Professional		$58.33	$127.67	$292.30
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 $56.45 / $129.59 / $262.33	Professional		$56.45	$129.59	$262.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $60.67 / $60.67 / $123.77	Professional		$60.67	$60.67	$123.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $320.00 / $610.00	Facility		$95.68	$320.00	$610.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $143.90 / $319.91	Professional		$64.09	$143.90	$319.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $176.81 / $221.54 / $453.63	Professional		$176.81	$221.54	$453.63
Medcost Facility/Professional Facility Modifier Low / Median / High Price $63.81 / $157.00 / $295.00	Facility		$63.81	$157.00	$295.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $208.00 / $343.40	Professional		$165.00	$208.00	$343.40
Sentara Facility/Professional Facility Modifier Low / Median / High Price $60.95 / $78.48 / $135.56	Facility		$60.95	$78.48	$135.56
Sentara Facility/Professional Professional Modifier Low / Median / High Price $138.31 / $195.26 / $421.87	Professional		$138.31	$195.26	$421.87
United Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $1,560.00 / $3,499.00	Facility		$250.00	$1,560.00	$3,499.00
United Facility/Professional Professional Modifier Low / Median / High Price $125.06 / $189.19 / $333.71	Professional		$125.06	$189.19	$333.71