Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $330.46 / $1,814.00 / $6,646.01	Facility		$330.46	$1,814.00	$6,646.01
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $60.06 / $165.23 / $180.28	Facility	52	$60.06	$165.23	$180.28
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.02 / $66.09 / $72.11	Facility	53	$24.02	$66.09	$72.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.38 / $262.98 / $503.29	Professional		$103.38	$262.98	$503.29
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 $104.22 / $253.33 / $416.42	Professional		$104.22	$253.33	$416.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $108.92 / $112.43 / $229.36	Professional		$108.92	$112.43	$229.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.49 / $511.22 / $664.58	Facility		$179.49	$511.22	$664.58
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.26 / $272.67 / $526.71	Professional		$118.26	$272.67	$526.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $272.45 / $340.58 / $540.15	Professional		$272.45	$340.58	$540.15
Medcost Facility/Professional Facility Modifier Low / Median / High Price $120.11 / $294.31 / $516.28	Facility		$120.11	$294.31	$516.28
Medcost Facility/Professional Professional Modifier Low / Median / High Price $302.33 / $409.20 / $606.90	Professional		$302.33	$409.20	$606.90
Sentara Facility/Professional Facility Modifier Low / Median / High Price $111.06 / $140.27 / $258.64	Facility		$111.06	$140.27	$258.64
Sentara Facility/Professional Professional Modifier Low / Median / High Price $310.17 / $392.88 / $709.71	Professional		$310.17	$392.88	$709.71
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 $251.10 / $401.61 / $582.79	Professional		$251.10	$401.61	$582.79