Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.81 / $2,840.00 / $8,294.00	Facility		$92.81	$2,840.00	$8,294.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.04 / $178.61 / $250.93	Professional		$77.04	$178.61	$250.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $135.41 / $135.41 / $135.41	Professional	50	$135.41	$135.41	$135.41
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 $75.29 / $96.29 / $160.74	Professional		$75.29	$96.29	$160.74
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $112.94 / $144.43 / $241.11	Professional	50	$112.94	$144.43	$241.11
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.02 / $90.04 / $1,757.00	Professional		$89.02	$90.04	$1,757.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.37 / $140.37 / $640.00	Facility		$140.37	$140.37	$640.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $112.30 / $112.30 / $112.30	Facility	52	$112.30	$112.30	$112.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.53 / $191.07 / $376.88	Professional		$84.53	$191.07	$376.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.60 / $269.95 / $307.75	Professional		$208.60	$269.95	$307.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $86.32 / $205.73 / $364.91	Facility		$86.32	$205.73	$364.91
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $294.37 / $432.51 / $883.57	Facility	50	$294.37	$432.51	$883.57
Medcost Facility/Professional Professional Modifier Low / Median / High Price $192.22 / $312.00 / $392.00	Professional		$192.22	$312.00	$392.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $82.39 / $112.11 / $990.39	Facility		$82.39	$112.11	$990.39
Sentara Facility/Professional Professional Modifier Low / Median / High Price $216.35 / $289.91 / $1,011.22	Professional		$216.35	$289.91	$1,011.22
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 $173.11 / $272.91 / $415.59	Professional		$173.11	$272.91	$415.59