Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.11 / $1,693.04 / $5,743.00	Facility		$133.11	$1,693.04	$5,743.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.74 / $118.02 / $178.00	Facility	52	$40.74	$118.02	$178.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.29 / $47.21 / $71.20	Facility	53	$16.29	$47.21	$71.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.84 / $165.62 / $452.69	Professional		$71.84	$165.62	$452.69
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 $70.95 / $166.10 / $405.20	Professional		$70.95	$166.10	$405.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $79.41 / $79.41 / $162.79	Professional		$79.41	$79.41	$162.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.96 / $495.64 / $617.00	Facility		$121.96	$495.64	$617.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.72 / $184.06 / $474.78	Professional		$79.72	$184.06	$474.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $267.16 / $333.95 / $525.00	Professional		$267.16	$333.95	$525.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $81.47 / $194.00 / $451.04	Facility		$81.47	$194.00	$451.04
Medcost Facility/Professional Professional Modifier Low / Median / High Price $201.00 / $316.00 / $527.00	Professional		$201.00	$316.00	$527.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $75.43 / $95.86 / $171.11	Facility		$75.43	$95.86	$171.11
Sentara Facility/Professional Professional Modifier Low / Median / High Price $174.88 / $281.75 / $650.54	Professional		$174.88	$281.75	$650.54
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 $168.00 / $270.58 / $505.40	Professional		$168.00	$270.58	$505.40