Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.65 / $605.00 / $6,827.70	Facility		$77.65	$605.00	$6,827.70
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $383.59 / $798.00 / $800.61	Facility	50	$383.59	$798.00	$800.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.10 / $92.54 / $144.36	Professional		$60.10	$92.54	$144.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $110.24 / $176.49 / $240.31	Professional	50	$110.24	$176.49	$240.31
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 $49.29 / $62.09 / $102.65	Professional		$49.29	$62.09	$102.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.83 / $93.13 / $153.97	Professional	50	$72.83	$93.13	$153.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $61.20 / $70.56 / $822.00	Professional		$61.20	$70.56	$822.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.34 / $90.34 / $420.00	Facility		$90.34	$90.34	$420.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.50 / $96.41 / $154.30	Professional		$57.50	$96.41	$154.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.17 / $91.58 / $108.23	Professional		$71.17	$91.58	$108.23
Medcost Facility/Professional Facility Modifier Low / Median / High Price $60.10 / $95.70 / $156.66	Facility		$60.10	$95.70	$156.66
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $146.16 / $207.93 / $318.64	Facility	50	$146.16	$207.93	$318.64
Medcost Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $136.00 / $173.00	Professional		$111.36	$136.00	$173.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $53.96 / $82.94 / $370.00	Facility		$53.96	$82.94	$370.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $119.51 / $379.00	Professional		$76.59	$119.51	$379.00
United Facility/Professional Facility Modifier Low / Median / High Price $206.00 / $819.00 / $2,364.00	Facility		$206.00	$819.00	$2,364.00
United Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $102.34 / $161.18	Professional		$58.94	$102.34	$161.18