Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,183.32 / $4,771.00 / $9,539.00	Facility		$1,183.32	$4,771.00	$9,539.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $591.66 / $591.66 / $1,420.62	Facility	52	$591.66	$591.66	$1,420.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,385.00 / $10,311.04 / $14,433.40	Facility		$6,385.00	$10,311.04	$14,433.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $610.00 / $1,187.10	Facility		$490.00	$610.00	$1,187.10
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $931.75 / $931.75 / $931.75	Facility	52	$931.75	$931.75	$931.75
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $116.47 / $116.47 / $116.47	Facility	AS	$116.47	$116.47	$116.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $961.54 / $1,187.78 / $1,707.44	Professional		$961.54	$1,187.78	$1,707.44
Medcost Facility/Professional Facility Modifier Low / Median / High Price $963.00 / $1,283.43 / $1,933.10	Facility		$963.00	$1,283.43	$1,933.10
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $172.00 / $254.56 / $416.52	Facility	80	$172.00	$254.56	$416.52
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $120.40 / $178.19 / $291.56	Facility	AS	$120.40	$178.19	$291.56
Sentara Facility/Professional Facility Modifier Low / Median / High Price $797.90 / $1,252.36 / $2,303.90	Facility		$797.90	$1,252.36	$2,303.90
United Facility/Professional Facility Modifier Low / Median / High Price $327.00 / $2,397.00 / $5,202.00	Facility		$327.00	$2,397.00	$5,202.00