Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.76 / $1,698.50 / $5,743.00	Facility		$57.76	$1,698.50	$5,743.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $94.74 / $190.93	Professional		$26.26	$94.74	$190.93
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 $23.08 / $29.08 / $54.19	Professional		$23.08	$29.08	$54.19
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.11 / $43.62 / $72.81	Professional	50	$34.11	$43.62	$72.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $27.01 / $30.11 / $2,012.00	Professional		$27.01	$30.11	$2,012.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.84 / $41.84 / $420.00	Facility		$41.84	$41.84	$420.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $77.86 / $259.19	Professional		$27.73	$77.86	$259.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.82 / $40.72 / $47.24	Professional		$31.82	$40.72	$47.24
Medcost Facility/Professional Facility Modifier Low / Median / High Price $31.82 / $130.08 / $294.85	Facility		$31.82	$130.08	$294.85
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $65.87 / $148.93 / $493.50	Facility	50	$65.87	$148.93	$493.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $49.23 / $210.00 / $360.00	Professional		$49.23	$210.00	$360.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $27.04 / $98.26 / $780.00	Facility		$27.04	$98.26	$780.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $37.74 / $173.68 / $780.00	Professional		$37.74	$173.68	$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 $27.76 / $62.52 / $352.86	Professional		$27.76	$62.52	$352.86