Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $456.79 / $3,469.00 / $9,250.00	Facility		$456.79	$3,469.00	$9,250.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $546.25 / $5,237.39 / $10,285.50	Facility	50	$546.25	$5,237.39	$10,285.50
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $81.84 / $228.40 / $264.72	Facility	52	$81.84	$228.40	$264.72
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.72 / $91.36 / $105.89	Facility	53	$32.72	$91.36	$105.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.30 / $352.62 / $806.33	Professional		$158.30	$352.62	$806.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $364.10 / $490.55 / $490.82	Professional	50	$364.10	$490.55	$490.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,032.00 / $6,548.00 / $7,221.00	Facility		$5,032.00	$6,548.00	$7,221.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.80 / $335.64 / $545.47	Professional		$151.80	$335.64	$545.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $227.70 / $503.46 / $818.20	Professional	50	$227.70	$503.46	$818.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $169.15 / $244.58 / $4,716.00	Professional		$169.15	$244.58	$4,716.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.27 / $378.02 / $832.06	Professional		$177.27	$378.02	$832.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.85 / $427.02 / $526.66	Professional		$355.85	$427.02	$526.66
Medcost Facility/Professional Facility Modifier Low / Median / High Price $176.47 / $419.64 / $794.18	Facility		$176.47	$419.64	$794.18
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $410.10 / $1,053.95 / $2,020.70	Facility	50	$410.10	$1,053.95	$2,020.70
Medcost Facility/Professional Professional Modifier Low / Median / High Price $458.00 / $676.00 / $1,000.00	Professional		$458.00	$676.00	$1,000.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $159.88 / $212.56 / $3,512.00	Facility		$159.88	$212.56	$3,512.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $415.32 / $629.54 / $3,512.00	Professional		$415.32	$629.54	$3,512.00
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 $393.59 / $648.27 / $1,040.29	Professional		$393.59	$648.27	$1,040.29