Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,272.48 / $5,422.11 / $9,814.45	Facility		$1,272.48	$5,422.11	$9,814.45
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $11,078.69 / $11,078.69 / $11,078.69	Facility	50	$11,078.69	$11,078.69	$11,078.69
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $513.20 / $513.20 / $1,558.52	Facility	54	$513.20	$513.20	$1,558.52
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $102.64 / $102.64 / $311.70	Facility	55	$102.64	$102.64	$311.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $684.27 / $935.45 / $1,765.63	Professional		$684.27	$935.45	$1,765.63
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $435.08 / $554.45 / $704.38	Professional	54	$435.08	$554.45	$704.38
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $87.02 / $110.89 / $140.88	Professional	55	$87.02	$110.89	$140.88
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 $679.49 / $868.92 / $1,206.58	Professional		$679.49	$868.92	$1,206.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $789.07 / $1,564.54 / $4,337.00	Professional		$789.07	$1,564.54	$4,337.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $826.04 / $826.04 / $826.04	Facility		$826.04	$826.04	$826.04
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $577.02 / $577.02 / $577.02	Facility	54	$577.02	$577.02	$577.02
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $123.65 / $123.65 / $123.65	Facility	55	$123.65	$123.65	$123.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $705.33 / $990.24 / $1,448.40	Professional		$705.33	$990.24	$1,448.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $685.40 / $806.35 / $1,040.77	Professional		$685.40	$806.35	$1,040.77
Medcost Facility/Professional Facility Modifier Low / Median / High Price $703.22 / $1,073.59 / $1,587.20	Facility		$703.22	$1,073.59	$1,587.20
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,578.47 / $1,901.72 / $3,143.24	Facility	50	$1,578.47	$1,901.72	$3,143.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $983.00 / $1,165.33 / $1,510.00	Professional		$983.00	$1,165.33	$1,510.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $733.88 / $1,084.01 / $8,098.00	Facility		$733.88	$1,084.01	$8,098.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $733.88 / $1,084.01 / $8,098.00	Professional		$733.88	$1,084.01	$8,098.00
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 $569.35 / $802.33 / $1,404.88	Professional		$569.35	$802.33	$1,404.88