Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $410.02 / $2,442.00 / $6,243.00	Facility		$410.02	$2,442.00	$6,243.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $105.93 / $179.61 / $429.52	Facility	52	$105.93	$179.61	$429.52
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $71.84 / $164.93 / $331.88	Facility	53	$71.84	$164.93	$331.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.09 / $353.23 / $608.89	Professional		$195.09	$353.23	$608.89
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $42.37 / $105.73 / $230.46	Professional	53	$42.37	$105.73	$230.46
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 $170.06 / $214.19 / $321.81	Professional		$170.06	$214.19	$321.81
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $74.84 / $126.25 / $226.25	Professional	53	$74.84	$126.25	$226.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $200.76 / $204.07 / $433.54	Professional		$200.76	$204.07	$433.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.83 / $610.00 / $1,250.00	Facility		$310.83	$610.00	$1,250.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $248.66 / $248.66	Facility	52	$248.66	$248.66	$248.66
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $62.17 / $62.17	Facility	53	$62.17	$62.17	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.82 / $359.38 / $623.50	Professional		$212.82	$359.38	$623.50
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $68.08 / $79.29 / $143.90	Professional	53	$68.08	$79.29	$143.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $319.61 / $401.43 / $624.17	Professional		$319.61	$401.43	$624.17
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $319.61 / $394.81 / $624.17	Professional	53	$319.61	$394.81	$624.17
Medcost Facility/Professional Facility Modifier Low / Median / High Price $211.85 / $376.01 / $626.16	Facility		$211.85	$376.01	$626.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $391.00 / $506.10 / $703.00	Professional		$391.00	$506.10	$703.00
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $478.20 / $478.20 / $478.20	Professional	53	$478.20	$478.20	$478.20
Sentara Facility/Professional Facility Modifier Low / Median / High Price $173.14 / $256.93 / $437.91	Facility		$173.14	$256.93	$437.91
Sentara Facility/Professional Professional Modifier Low / Median / High Price $256.23 / $463.62 / $824.98	Professional		$256.23	$463.62	$824.98
Sentara Facility/Professional Professional Modifier 53 Low / Median / High Price $160.96 / $236.28 / $407.74	Professional	53	$160.96	$236.28	$407.74
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 $257.20 / $403.39 / $633.53	Professional		$257.20	$403.39	$633.53