Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.94 / $1,719.00 / $8,900.00	Facility		$265.94	$1,719.00	$8,900.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $25.05 / $63.85 / $99.27	Facility	53	$25.05	$63.85	$99.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.81 / $280.14 / $542.75	Professional		$140.81	$280.14	$542.75
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 $149.49 / $303.44 / $493.14	Professional		$149.49	$303.44	$493.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $167.06 / $251.97 / $3,774.00	Professional		$167.06	$251.97	$3,774.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.43 / $298.69 / $594.25	Professional		$178.43	$298.69	$594.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $321.76 / $386.11 / $476.20	Professional		$321.76	$386.11	$476.20
Medcost Facility/Professional Facility Modifier Low / Median / High Price $170.48 / $319.27 / $537.12	Facility		$170.48	$319.27	$537.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $325.00 / $372.87 / $671.00	Professional		$325.00	$372.87	$671.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $171.97 / $235.94 / $3,512.00	Facility		$171.97	$235.94	$3,512.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $260.61 / $411.01 / $3,512.00	Professional		$260.61	$411.01	$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 $217.22 / $351.51 / $659.55	Professional		$217.22	$351.51	$659.55