Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.00 / $2,561.00 / $8,294.00	Facility		$812.00	$2,561.00	$8,294.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $489.65 / $489.65 / $1,477.42	Facility	54	$489.65	$489.65	$1,477.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.71 / $848.14 / $1,805.63	Professional		$603.71	$848.14	$1,805.63
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.08 / $121.81 / $159.32	Professional	55	$95.08	$121.81	$159.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,153.00 / $7,363.00 / $9,410.00	Facility		$6,153.00	$7,363.00	$9,410.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $737.78 / $947.63 / $1,339.19	Professional		$737.78	$947.63	$1,339.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $798.30 / $1,556.68 / $5,354.00	Professional		$798.30	$1,556.68	$5,354.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $914.91 / $914.91 / $914.91	Facility		$914.91	$914.91	$914.91
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $640.44 / $640.44 / $640.44	Facility	54	$640.44	$640.44	$640.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $668.21 / $929.62 / $1,489.44	Professional		$668.21	$929.62	$1,489.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $762.87 / $897.49 / $1,144.81	Professional		$762.87	$897.49	$1,144.81
Medcost Facility/Professional Facility Modifier Low / Median / High Price $738.55 / $928.00 / $1,442.26	Facility		$738.55	$928.00	$1,442.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $924.00 / $1,022.00 / $1,554.60	Professional		$924.00	$1,022.00	$1,554.60
Sentara Facility/Professional Facility Modifier Low / Median / High Price $668.55 / $956.93 / $7,420.00	Facility		$668.55	$956.93	$7,420.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $668.55 / $956.93 / $7,420.00	Professional		$668.55	$956.93	$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 $534.77 / $755.44 / $1,350.01	Professional		$534.77	$755.44	$1,350.01