Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $645.65 / $5,248.07	Facility		$95.50	$645.65	$5,248.07
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,445.44 / $1,445.44 / $2,041.74	Facility	50	$1,445.44	$1,445.44	$2,041.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $199.53 / $537.03	Professional		$64.57	$199.53	$537.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $218.78 / $380.19	Professional	50	$144.54	$218.78	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $162.18	Professional		$66.07	$95.50	$162.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $144.54 / $245.47	Professional	50	$100.00	$144.54	$245.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $954.99	Professional		$64.57	$93.33	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $173.78 / $380.19	Professional		$67.61	$173.78	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $331.13 / $398.11	Professional		$263.03	$331.13	$398.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Medcost Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $190.55 / $398.11	Facility		$66.07	$190.55	$398.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Sentara Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $89.13 / $1,288.25	Facility		$66.07	$89.13	$1,288.25
Sentara Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $1,288.25	Professional		$194.98	$275.42	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,202.26 / $2,454.71	Facility		$218.78	$1,202.26	$2,454.71
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $144.54 / $354.81	Professional		$58.88	$144.54	$354.81