Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.67 / $1,397.00 / $5,042.39	Facility		$228.67	$1,397.00	$5,042.39
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $900.36 / $3,502.68 / $5,065.35	Facility	50	$900.36	$3,502.68	$5,065.35
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.15 / $50.46 / $72.53	Facility	53	$22.15	$50.46	$72.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.99 / $219.72 / $398.12	Professional		$105.99	$219.72	$398.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $152.91 / $364.43 / $534.74	Professional	50	$152.91	$364.43	$534.74
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $22.15 / $36.58 / $52.10	Professional	53	$22.15	$36.58	$52.10
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 $99.92 / $130.47 / $217.37	Professional		$99.92	$130.47	$217.37
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $151.26 / $195.72 / $326.06	Professional	50	$151.26	$195.72	$326.06
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $119.88 / $123.79 / $2,012.00	Professional		$119.88	$123.79	$2,012.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.07 / $188.07 / $420.00	Facility		$188.07	$188.07	$420.00
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.61 / $37.61 / $37.61	Facility	53	$37.61	$37.61	$37.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.38 / $232.27 / $432.59	Professional		$113.38	$232.27	$432.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $232.27 / $300.36 / $354.97	Professional		$232.27	$300.36	$354.97
Medcost Facility/Professional Facility Modifier Low / Median / High Price $119.58 / $240.85 / $440.28	Facility		$119.58	$240.85	$440.28
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $396.83 / $538.50 / $1,089.05	Facility	50	$396.83	$538.50	$1,089.05
Medcost Facility/Professional Professional Modifier Low / Median / High Price $269.00 / $340.25 / $515.00	Professional		$269.00	$340.25	$515.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $108.66 / $146.37 / $1,101.84	Facility		$108.66	$146.37	$1,101.84
Sentara Facility/Professional Professional Modifier Low / Median / High Price $238.08 / $336.38 / $1,125.03	Professional		$238.08	$336.38	$1,125.03
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 $192.59 / $317.82 / $530.40	Professional		$192.59	$317.82	$530.40