Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,138.74 / $5,410.00 / $12,393.43	Facility		$1,138.74	$5,410.00	$12,393.43
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $587.48 / $587.48 / $1,781.78	Facility	54	$587.48	$587.48	$1,781.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $703.81 / $860.91 / $1,434.55	Professional		$703.81	$860.91	$1,434.55
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $105.57 / $134.19 / $170.81	Professional	55	$105.57	$134.19	$170.81
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 $804.82 / $1,039.22 / $1,460.89	Professional		$804.82	$1,039.22	$1,460.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $956.02 / $1,878.36 / $5,354.00	Professional		$956.02	$1,878.36	$5,354.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $999.42 / $999.42 / $999.42	Facility		$999.42	$999.42	$999.42
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $698.63 / $698.63 / $698.63	Facility	54	$698.63	$698.63	$698.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $806.98 / $1,071.07 / $1,700.38	Professional		$806.98	$1,071.07	$1,700.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $829.58 / $975.98 / $1,258.96	Professional		$829.58	$975.98	$1,258.96
Medcost Facility/Professional Facility Modifier Low / Median / High Price $830.31 / $1,114.50 / $1,706.65	Facility		$830.31	$1,114.50	$1,706.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,124.00 / $1,262.00 / $1,688.61	Professional		$1,124.00	$1,262.00	$1,688.61
Sentara Facility/Professional Facility Modifier Low / Median / High Price $805.53 / $1,110.72 / $7,420.00	Facility		$805.53	$1,110.72	$7,420.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $805.53 / $1,110.72 / $7,420.00	Professional		$805.53	$1,110.72	$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 $660.66 / $863.04 / $1,502.72	Professional		$660.66	$863.04	$1,502.72