Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,297.84 / $9,049.98 / $16,216.52	Facility		$4,297.84	$9,049.98	$16,216.52
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,855.15 / $3,855.15 / $13,392.68	Facility	22	$3,855.15	$3,855.15	$13,392.68
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $371.81 / $371.81 / $890.22	Facility	52	$371.81	$371.81	$890.22
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $148.72 / $148.72 / $356.09	Facility	53	$148.72	$148.72	$356.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $641.16 / $773.49 / $1,433.68	Professional		$641.16	$773.49	$1,433.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,525.00 / $11,065.00 / $12,418.00	Facility		$8,525.00	$11,065.00	$12,418.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $612.19 / $782.86 / $1,145.00	Professional		$612.19	$782.86	$1,145.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $704.18 / $757.82 / $1,553.53	Professional		$704.18	$757.82	$1,553.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $610.00 / $1,727.00 / $3,218.20	Facility		$610.00	$1,727.00	$3,218.20
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $594.13 / $594.13 / $594.13	Facility	52	$594.13	$594.13	$594.13
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $148.53 / $148.53 / $148.53	Facility	53	$148.53	$148.53	$148.53
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $74.27 / $74.27 / $74.27	Facility	AS	$74.27	$74.27	$74.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $637.54 / $856.83 / $1,482.48	Professional		$637.54	$856.83	$1,482.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.85 / $750.22 / $1,204.66	Professional		$616.85	$750.22	$1,204.66
Medcost Facility/Professional Facility Modifier Low / Median / High Price $697.27 / $912.61 / $1,360.81	Facility		$697.27	$912.61	$1,360.81
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $176.97 / $233.42 / $341.83	Facility	80	$176.97	$233.42	$341.83
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $121.66 / $163.38 / $239.28	Facility	AS	$121.66	$163.38	$239.28
Medcost Facility/Professional Professional Modifier Low / Median / High Price $821.00 / $924.45 / $1,532.71	Professional		$821.00	$924.45	$1,532.71
Sentara Facility/Professional Facility Modifier Low / Median / High Price $696.24 / $857.68 / $1,551.85	Facility		$696.24	$857.68	$1,551.85
Sentara Facility/Professional Professional Modifier Low / Median / High Price $696.24 / $857.68 / $1,551.85	Professional		$696.24	$857.68	$1,551.85
United Facility/Professional Facility Modifier Low / Median / High Price $2,020.00 / $11,677.00 / $23,926.00	Facility		$2,020.00	$11,677.00	$23,926.00
United Facility/Professional Professional Modifier Low / Median / High Price $545.41 / $818.15 / $1,293.69	Professional		$545.41	$818.15	$1,293.69