Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $589.10 / $2,190.00 / $8,294.00	Facility		$589.10	$2,190.00	$8,294.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $389.72 / $441.83 / $1,178.23	Facility	54	$389.72	$441.83	$1,178.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.63 / $646.21 / $1,029.39	Professional		$519.63	$646.21	$1,029.39
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $388.47 / $447.81 / $669.62	Professional	54	$388.47	$447.81	$669.62
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $77.69 / $89.56 / $133.91	Professional	55	$77.69	$89.56	$133.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,060.00 / $3,693.00 / $4,290.00	Facility		$3,060.00	$3,693.00	$4,290.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $551.34 / $693.75 / $979.01	Professional		$551.34	$693.75	$979.01
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $827.01 / $1,040.63 / $1,468.52	Professional	50	$827.01	$1,040.63	$1,468.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $642.66 / $1,253.21 / $2,413.00	Professional		$642.66	$1,253.21	$2,413.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $994.17 / $994.17 / $994.17	Facility		$994.17	$994.17	$994.17
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $695.92 / $695.92 / $695.92	Facility	54	$695.92	$695.92	$695.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.29 / $752.53 / $1,248.58	Professional		$549.29	$752.53	$1,248.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $647.55 / $761.83 / $971.24	Professional		$647.55	$761.83	$971.24
Medcost Facility/Professional Facility Modifier Low / Median / High Price $570.45 / $762.45 / $1,150.31	Facility		$570.45	$762.45	$1,150.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $810.00 / $929.00 / $1,306.69	Professional		$810.00	$929.00	$1,306.69
Sentara Facility/Professional Facility Modifier Low / Median / High Price $549.57 / $735.86 / $3,398.99	Facility		$549.57	$735.86	$3,398.99
Sentara Facility/Professional Professional Modifier Low / Median / High Price $600.86 / $824.86 / $3,398.99	Professional		$600.86	$824.86	$3,398.99
United Facility/Professional Facility Modifier Low / Median / High Price $1,911.00 / $3,175.00 / $5,340.00	Facility		$1,911.00	$3,175.00	$5,340.00
United Facility/Professional Professional Modifier Low / Median / High Price $475.85 / $647.91 / $1,090.91	Professional		$475.85	$647.91	$1,090.91