Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $568.20 / $5,040.00 / $10,232.00	Facility		$568.20	$5,040.00	$10,232.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $309.26 / $426.15 / $935.48	Facility	54	$309.26	$426.15	$935.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $411.75 / $569.33 / $1,196.07	Professional		$411.75	$569.33	$1,196.07
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 $437.63 / $559.63 / $777.10	Professional		$437.63	$559.63	$777.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $509.50 / $993.52 / $4,337.00	Professional		$509.50	$993.52	$4,337.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $790.70 / $790.70 / $790.70	Facility		$790.70	$790.70	$790.70
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $553.49 / $553.49 / $553.49	Facility	54	$553.49	$553.49	$553.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $445.23 / $668.35 / $1,190.08	Professional		$445.23	$668.35	$1,190.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $625.15 / $735.47 / $931.14	Professional		$625.15	$735.47	$931.14
Medcost Facility/Professional Facility Modifier Low / Median / High Price $454.41 / $673.83 / $1,106.72	Facility		$454.41	$673.83	$1,106.72
Medcost Facility/Professional Professional Modifier Low / Median / High Price $803.00 / $888.00 / $1,219.00	Professional		$803.00	$888.00	$1,219.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $452.92 / $583.94 / $7,420.00	Facility		$452.92	$583.94	$7,420.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $545.17 / $818.27 / $7,420.00	Professional		$545.17	$818.27	$7,420.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,349.00 / $6,870.00 / $12,739.00	Facility		$4,349.00	$6,870.00	$12,739.00
United Facility/Professional Professional Modifier Low / Median / High Price $461.11 / $633.52 / $1,099.68	Professional		$461.11	$633.52	$1,099.68