Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $2,570.40 / $6,456.54	Facility		$380.19	$2,570.40	$6,456.54
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	52	$426.58	$426.58	$426.58
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $104.71 / $177.83 / $338.84	Facility	53	$104.71	$177.83	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $363.08 / $954.99	Professional		$181.97	$363.08	$954.99
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $154.88 / $288.40	Professional	53	$83.18	$154.88	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,570.40 / $2,951.21	Facility		$2,137.96	$2,570.40	$2,951.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $371.54	Professional		$177.83	$239.88	$371.54
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $81.28 / $125.89 / $199.53	Professional	53	$81.28	$125.89	$199.53
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $213.80 / $1,737.80	Professional		$177.83	$213.80	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $501.19 / $1,023.29	Facility		$457.09	$501.19	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $354.81 / $616.60	Professional		$208.93	$354.81	$616.60
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $67.61 / $79.43 / $204.17	Professional	53	$67.61	$79.43	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $741.31	Professional		$363.08	$457.09	$741.31
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $363.08 / $457.09 / $741.31	Professional	53	$363.08	$457.09	$741.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $562.34 / $794.33	Professional		$478.63	$562.34	$794.33
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $151.36 / $181.97 / $204.17	Professional	53	$151.36	$181.97	$204.17
Medcost Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $380.19 / $676.08	Facility		$204.17	$380.19	$676.08
Medcost Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $870.96	Professional		$346.74	$346.74	$870.96
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $478.63 / $478.63 / $478.63	Professional	53	$478.63	$478.63	$478.63
Sentara Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $245.47 / $478.63	Facility		$162.18	$245.47	$478.63
Sentara Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $446.68 / $912.01	Professional		$204.17	$446.68	$912.01
Sentara Facility/Professional Professional Modifier 53 Low / Median / High Price $154.88 / $204.17 / $354.81	Professional	53	$154.88	$204.17	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $2,818.38 / $5,754.40	Facility		$512.86	$2,818.38	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $316.23 / $588.84	Professional		$173.78	$316.23	$588.84