Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.95 / $5,282.00 / $12,436.09	Facility		$109.95	$5,282.00	$12,436.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.92 / $113.55 / $205.85	Professional		$58.92	$113.55	$205.85
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $130.29 / $199.97 / $199.97	Professional	50	$130.29	$199.97	$199.97
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 $57.46 / $73.48 / $121.50	Professional		$57.46	$73.48	$121.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $86.20 / $110.23 / $182.25	Professional	50	$86.20	$110.23	$182.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $67.87 / $2,012.00	Professional		$57.03	$67.87	$2,012.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.26 / $109.26 / $420.00	Facility		$109.26	$109.26	$420.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.60 / $108.99 / $198.60	Professional		$63.60	$108.99	$198.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.58 / $141.54 / $166.70	Professional		$110.58	$141.54	$166.70
Medcost Facility/Professional Facility Modifier Low / Median / High Price $69.80 / $114.79 / $193.74	Facility		$69.80	$114.79	$193.74
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $132.32 / $230.85 / $472.23	Facility	50	$132.32	$230.85	$472.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $150.00 / $204.03	Professional		$104.00	$150.00	$204.03
Sentara Facility/Professional Facility Modifier Low / Median / High Price $60.14 / $85.34 / $780.00	Facility		$60.14	$85.34	$780.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $134.37 / $780.00	Professional		$80.48	$134.37	$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 $61.81 / $106.31 / $195.02	Professional		$61.81	$106.31	$195.02