Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.25 / $812.00 / $8,294.00	Facility		$87.25	$812.00	$8,294.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $25.91 / $43.63 / $93.79	Facility	52	$25.91	$43.63	$93.79
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $10.36 / $17.45 / $37.52	Facility	53	$10.36	$17.45	$37.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.37 / $103.40 / $179.89	Professional		$76.37	$103.40	$179.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.91 / $43.63 / $52.19	Professional	52	$25.91	$43.63	$52.19
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $10.36 / $17.45 / $20.88	Professional	53	$10.36	$17.45	$20.88
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 $62.37 / $97.10 / $146.09	Professional		$62.37	$97.10	$146.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $72.87 / $115.93 / $974.00	Professional		$72.87	$115.93	$974.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $122.20 / $185.07	Professional		$74.50	$122.20	$185.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.03 / $114.04 / $140.63	Professional		$95.03	$114.04	$140.63
Medcost Facility/Professional Facility Modifier Low / Median / High Price $74.87 / $114.87 / $177.08	Facility		$74.87	$114.87	$177.08
Medcost Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $151.19 / $215.00	Professional		$132.00	$151.19	$215.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $71.05 / $107.32 / $805.00	Facility		$71.05	$107.32	$805.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $102.02 / $141.65 / $805.00	Professional		$102.02	$141.65	$805.00
United Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $1,045.00 / $2,364.00	Facility		$296.00	$1,045.00	$2,364.00
United Facility/Professional Professional Modifier Low / Median / High Price $87.19 / $141.94 / $212.91	Professional		$87.19	$141.94	$212.91