Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,222.57 / $6,172.09 / $9,539.00	Facility		$1,222.57	$6,172.09	$9,539.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $110.15 / $110.15 / $333.85	Facility	53	$110.15	$110.15	$333.85
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $413.05 / $413.05 / $1,251.95	Facility	54	$413.05	$413.05	$1,251.95
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $82.61 / $82.61 / $250.39	Facility	55	$82.61	$82.61	$250.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $539.13 / $686.84 / $1,446.83	Professional		$539.13	$686.84	$1,446.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $211.63 / $275.37 / $343.42	Professional	52	$211.63	$275.37	$343.42
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $317.45 / $413.05 / $515.13	Professional	54	$317.45	$413.05	$515.13
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.49 / $82.61 / $103.03	Professional	55	$63.49	$82.61	$103.03
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 $496.02 / $634.29 / $880.78	Professional		$496.02	$634.29	$880.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $744.03 / $951.45 / $1,321.18	Professional	50	$744.03	$951.45	$1,321.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $576.60 / $1,141.45 / $3,472.00	Professional		$576.60	$1,141.45	$3,472.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.32 / $602.32 / $602.32	Facility		$602.32	$602.32	$602.32
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $120.35 / $120.35 / $120.35	Facility	53	$120.35	$120.35	$120.35
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $421.21 / $421.21 / $421.21	Facility	54	$421.21	$421.21	$421.21
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $90.26 / $90.26 / $90.26	Facility	55	$90.26	$90.26	$90.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $522.58 / $758.68 / $1,144.44	Professional		$522.58	$758.68	$1,144.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $500.99 / $589.40 / $760.14	Professional		$500.99	$589.40	$760.14
Medcost Facility/Professional Facility Modifier Low / Median / High Price $550.73 / $851.83 / $1,507.19	Facility		$550.73	$851.83	$1,507.19
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,152.20 / $1,428.73 / $2,844.00	Facility	50	$1,152.20	$1,428.73	$2,844.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $791.00 / $910.00 / $1,083.00	Professional		$791.00	$910.00	$1,083.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $552.84 / $811.83 / $7,420.00	Facility		$552.84	$811.83	$7,420.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $552.84 / $811.83 / $7,420.00	Professional		$552.84	$811.83	$7,420.00
United Facility/Professional Facility Modifier Low / Median / High Price $3,524.00 / $5,979.00 / $13,217.00	Facility		$3,524.00	$5,979.00	$13,217.00
United Facility/Professional Professional Modifier Low / Median / High Price $418.19 / $585.36 / $1,030.68	Professional		$418.19	$585.36	$1,030.68