Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.59 / $1,219.00 / $5,636.00	Facility		$199.59	$1,219.00	$5,636.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $42.28 / $105.51 / $137.05	Facility	52	$42.28	$105.51	$137.05
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.91 / $42.20 / $54.82	Facility	53	$16.91	$42.20	$54.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.79 / $211.00 / $368.34	Professional		$91.79	$211.00	$368.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.28 / $73.86 / $137.05	Professional	52	$42.28	$73.86	$137.05
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $16.91 / $29.54 / $54.82	Professional	53	$16.91	$29.54	$54.82
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 $78.53 / $194.97 / $327.10	Professional		$78.53	$194.97	$327.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $87.19 / $126.95 / $2,413.00	Professional		$87.19	$126.95	$2,413.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.18 / $214.54 / $384.82	Professional		$104.18	$214.54	$384.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $209.31 / $251.17 / $309.77	Professional		$209.31	$251.17	$309.77
Medcost Facility/Professional Facility Modifier Low / Median / High Price $91.79 / $211.31 / $386.15	Facility		$91.79	$211.31	$386.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $204.00 / $279.00 / $446.00	Professional		$204.00	$279.00	$446.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $89.16 / $149.44 / $1,171.00	Facility		$89.16	$149.44	$1,171.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $203.22 / $284.51 / $1,171.00	Professional		$203.22	$284.51	$1,171.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,066.00 / $1,820.00 / $3,880.00	Facility		$1,066.00	$1,820.00	$3,880.00
United Facility/Professional Professional Modifier Low / Median / High Price $182.04 / $277.77 / $429.82	Professional		$182.04	$277.77	$429.82