Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.82 / $3,633.00 / $8,920.00	Facility		$95.82	$3,633.00	$8,920.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.51 / $47.91 / $115.20	Facility	52	$30.51	$47.91	$115.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.01 / $83.13 / $95.82	Professional		$61.01	$83.13	$95.82
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 $58.08 / $74.28 / $124.00	Professional		$58.08	$74.28	$124.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $73.53 / $1,757.00	Professional		$66.84	$73.53	$1,757.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.65 / $72.65 / $420.00	Facility		$72.65	$72.65	$420.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.37 / $56.37 / $56.37	Facility	52	$56.37	$56.37	$56.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.09 / $103.37 / $179.07	Professional		$62.09	$103.37	$179.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.62 / $78.87 / $91.20	Professional		$61.62	$78.87	$91.20
Medcost Facility/Professional Facility Modifier Low / Median / High Price $68.94 / $112.49 / $214.82	Facility		$68.94	$112.49	$214.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $91.74 / $116.00 / $206.00	Professional		$91.74	$116.00	$206.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $67.97 / $107.01 / $1,171.00	Facility		$67.97	$107.01	$1,171.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $67.97 / $107.01 / $1,171.00	Professional		$67.97	$107.01	$1,171.00
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 $51.68 / $94.75 / $203.87	Professional		$51.68	$94.75	$203.87