Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.27 / $987.64 / $7,275.00	Facility		$179.27	$987.64	$7,275.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $134.44 / $169.99 / $499.64	Facility	54	$134.44	$169.99	$499.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.27 / $277.54 / $522.60	Professional		$179.27	$277.54	$522.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $501.82 / $522.73 / $2,233.42	Professional	50	$501.82	$522.73	$2,233.42
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $134.44 / $164.36 / $235.38	Professional	54	$134.44	$164.36	$235.38
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $26.89 / $31.87 / $47.08	Professional	55	$26.89	$31.87	$47.08
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 $187.16 / $239.34 / $346.41	Professional		$187.16	$239.34	$346.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $280.74 / $359.01 / $498.52	Professional	50	$280.74	$359.01	$498.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $216.57 / $428.36 / $2,413.00	Professional		$216.57	$428.36	$2,413.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $340.33 / $340.33 / $340.33	Facility		$340.33	$340.33	$340.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $238.23 / $238.23 / $238.23	Facility	54	$238.23	$238.23	$238.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.42 / $323.51 / $498.10	Professional		$209.42	$323.51	$498.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $226.98 / $267.02 / $342.53	Professional		$226.98	$267.02	$342.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $202.40 / $318.74 / $580.38	Facility		$202.40	$318.74	$580.38
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $436.55 / $599.61 / $1,228.50	Facility	50	$436.55	$599.61	$1,228.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $425.78 / $478.68	Professional		$302.00	$425.78	$478.68
Sentara Facility/Professional Facility Modifier Low / Median / High Price $204.28 / $329.28 / $2,755.00	Facility		$204.28	$329.28	$2,755.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $246.98 / $371.25 / $2,755.00	Professional		$246.98	$371.25	$2,755.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,066.00 / $1,890.00 / $3,765.00	Facility		$1,066.00	$1,890.00	$3,765.00
United Facility/Professional Professional Modifier Low / Median / High Price $187.68 / $262.75 / $451.68	Professional		$187.68	$262.75	$451.68