Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $816.99 / $5,282.00 / $11,025.00	Facility		$816.99	$5,282.00	$11,025.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $595.11 / $612.74 / $1,858.74	Facility	54	$595.11	$612.74	$1,858.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $700.39 / $816.99 / $1,749.00	Professional		$700.39	$816.99	$1,749.00
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 $570.70 / $729.80 / $1,057.29	Professional		$570.70	$729.80	$1,057.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $667.01 / $1,683.65 / $5,354.00	Professional		$667.01	$1,683.65	$5,354.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $692.33 / $692.33 / $692.33	Facility		$692.33	$692.33	$692.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $484.63 / $484.63 / $484.63	Facility	54	$484.63	$484.63	$484.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $601.91 / $1,012.86 / $1,646.19	Professional		$601.91	$1,012.86	$1,646.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $578.94 / $681.11 / $873.35	Professional		$578.94	$681.11	$873.35
Medcost Facility/Professional Facility Modifier Low / Median / High Price $646.80 / $1,057.29 / $1,632.63	Facility		$646.80	$1,057.29	$1,632.63
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $175.71 / $262.52 / $529.11	Facility	80	$175.71	$262.52	$529.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,036.00 / $1,191.00 / $1,734.00	Professional		$1,036.00	$1,191.00	$1,734.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $714.96 / $1,185.24 / $9,929.00	Facility		$714.96	$1,185.24	$9,929.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $714.96 / $1,185.24 / $9,929.00	Professional		$714.96	$1,185.24	$9,929.00
United Facility/Professional Facility Modifier Low / Median / High Price $6,693.00 / $11,671.00 / $21,639.00	Facility		$6,693.00	$11,671.00	$21,639.00
United Facility/Professional Professional Modifier Low / Median / High Price $684.39 / $994.62 / $1,736.95	Professional		$684.39	$994.62	$1,736.95