Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.80 / $1,814.00 / $7,332.00	Facility		$251.80	$1,814.00	$7,332.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $106.79 / $342.39 / $526.15	Facility	52	$106.79	$342.39	$526.15
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $42.72 / $136.96 / $210.46	Facility	53	$42.72	$136.96	$210.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.58 / $684.27 / $1,253.17	Professional		$213.58	$684.27	$1,253.17
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 $196.68 / $528.29 / $1,216.04	Professional		$196.68	$528.29	$1,216.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $217.64 / $332.77 / $916.00	Professional		$217.64	$332.77	$916.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.48 / $590.66 / $1,626.26	Professional		$233.48	$590.66	$1,626.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.73 / $995.74 / $1,228.07	Professional		$691.73	$995.74	$1,228.07
Medcost Facility/Professional Facility Modifier Low / Median / High Price $234.88 / $829.78 / $1,503.75	Facility		$234.88	$829.78	$1,503.75
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $542.40 / $1,698.18 / $2,437.34	Facility	50	$542.40	$1,698.18	$2,437.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $466.97 / $1,077.14 / $2,053.00	Professional		$466.97	$1,077.14	$2,053.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $225.74 / $295.72 / $4,071.00	Facility		$225.74	$295.72	$4,071.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $914.70 / $1,170.97 / $4,142.09	Professional		$914.70	$1,170.97	$4,142.09
United Facility/Professional Facility Modifier Low / Median / High Price $4,349.00 / $7,061.00 / $12,739.00	Facility		$4,349.00	$7,061.00	$12,739.00
United Facility/Professional Professional Modifier Low / Median / High Price $770.19 / $1,229.66 / $1,846.50	Professional		$770.19	$1,229.66	$1,846.50