Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.34 / $2,004.00 / $8,294.00	Facility		$64.34	$2,004.00	$8,294.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.23 / $90.02 / $147.65	Professional		$55.23	$90.02	$147.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.98 / $59.98 / $195.60	Professional	50	$59.98	$59.98	$195.60
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 $51.49 / $64.84 / $107.21	Professional		$51.49	$64.84	$107.21
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $76.06 / $97.27 / $160.82	Professional	50	$76.06	$97.27	$160.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $66.56 / $1,757.00	Professional		$60.28	$66.56	$1,757.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.98 / $94.98 / $420.00	Facility		$94.98	$94.98	$420.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $106.65 / $193.50	Professional		$62.76	$106.65	$193.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.80 / $104.70 / $122.94	Professional		$81.80	$104.70	$122.94
Medcost Facility/Professional Facility Modifier Low / Median / High Price $62.41 / $106.17 / $203.78	Facility		$62.41	$106.17	$203.78
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $171.59 / $249.92 / $383.87	Facility	50	$171.59	$249.92	$383.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $129.10 / $182.00 / $213.00	Professional		$129.10	$182.00	$213.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $58.63 / $89.04 / $780.00	Facility		$58.63	$89.04	$780.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $94.69 / $161.63 / $780.00	Professional		$94.69	$161.63	$780.00
United Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $1,890.00 / $3,765.00	Facility		$921.00	$1,890.00	$3,765.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.22 / $124.17 / $212.02	Professional		$69.22	$124.17	$212.02