Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $386.83 / $1,157.50 / $5,412.00	Facility		$386.83	$1,157.50	$5,412.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $113.78 / $225.41 / $334.96	Facility	52	$113.78	$225.41	$334.96
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $45.51 / $90.16 / $133.97	Facility	53	$45.51	$90.16	$133.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.61 / $420.89 / $719.43	Professional		$209.61	$420.89	$719.43
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 $184.41 / $232.26 / $357.92	Professional		$184.41	$232.26	$357.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $217.60 / $221.26 / $451.37	Professional		$217.60	$221.26	$451.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.16 / $640.94 / $1,250.00	Facility		$338.16	$640.94	$1,250.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.83 / $416.34 / $758.58	Professional		$230.83	$416.34	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $414.60 / $512.42 / $789.12	Professional		$414.60	$512.42	$789.12
Medcost Facility/Professional Facility Modifier Low / Median / High Price $229.97 / $450.82 / $745.97	Facility		$229.97	$450.82	$745.97
Medcost Facility/Professional Professional Modifier Low / Median / High Price $478.00 / $607.00 / $846.15	Professional		$478.00	$607.00	$846.15
Sentara Facility/Professional Facility Modifier Low / Median / High Price $223.11 / $294.20 / $480.84	Facility		$223.11	$294.20	$480.84
Sentara Facility/Professional Professional Modifier Low / Median / High Price $441.67 / $570.04 / $1,005.50	Professional		$441.67	$570.04	$1,005.50
United Facility/Professional Facility Modifier Low / Median / High Price $516.00 / $2,464.00 / $5,226.00	Facility		$516.00	$2,464.00	$5,226.00
United Facility/Professional Professional Modifier Low / Median / High Price $344.37 / $532.63 / $809.70	Professional		$344.37	$532.63	$809.70