Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $514.02 / $5,087.00 / $9,441.62	Facility		$514.02	$5,087.00	$9,441.62
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,567.00 / $3,567.00 / $3,567.00	Facility	22	$3,567.00	$3,567.00	$3,567.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $129.94 / $600.14 / $1,226.81	Facility	52	$129.94	$600.14	$1,226.81
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.18 / $151.58 / $304.02	Facility	53	$38.18	$151.58	$304.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.38 / $471.02 / $2,040.45	Professional		$237.38	$471.02	$2,040.45
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.18 / $90.60 / $304.02	Professional	53	$38.18	$90.60	$304.02
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 $228.36 / $683.90 / $1,799.28	Professional		$228.36	$683.90	$1,799.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $254.63 / $383.95 / $4,284.00	Professional		$254.63	$383.95	$4,284.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.95 / $445.18 / $2,544.35	Professional		$263.95	$445.18	$2,544.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,185.03 / $1,422.04 / $1,753.84	Professional		$1,185.03	$1,422.04	$1,753.84
Medcost Facility/Professional Facility Modifier Low / Median / High Price $259.89 / $474.51 / $1,976.12	Facility		$259.89	$474.51	$1,976.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $430.00 / $975.00 / $1,972.00	Professional		$430.00	$975.00	$1,972.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $261.39 / $340.18 / $4,071.00	Facility		$261.39	$340.18	$4,071.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $350.73 / $1,807.53 / $4,283.00	Professional		$350.73	$1,807.53	$4,283.00
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 $322.70 / $1,376.67 / $3,049.30	Professional		$322.70	$1,376.67	$3,049.30