Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $723.49 / $5,412.00 / $13,209.00	Facility		$723.49	$5,412.00	$13,209.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $542.62 / $542.62 / $806.00	Facility	54	$542.62	$542.62	$806.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.44 / $853.76 / $1,356.62	Professional		$663.44	$853.76	$1,356.62
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $99.52 / $127.44 / $161.19	Professional	55	$99.52	$127.44	$161.19
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 $762.73 / $979.69 / $1,384.48	Professional		$762.73	$979.69	$1,384.48
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $879.00 / $1,714.05 / $8,031.00	Professional		$879.00	$1,714.05	$8,031.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $949.72 / $949.72 / $949.72	Facility		$949.72	$949.72	$949.72
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $662.09 / $662.09 / $662.09	Facility	54	$662.09	$662.09	$662.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.58 / $1,010.84 / $1,641.18	Professional		$776.58	$1,010.84	$1,641.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $785.18 / $923.74 / $1,194.52	Professional		$785.18	$923.74	$1,194.52
Medcost Facility/Professional Facility Modifier Low / Median / High Price $723.49 / $1,075.10 / $1,504.54	Facility		$723.49	$1,075.10	$1,504.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,170.00 / $1,471.96 / $1,994.45	Professional		$1,170.00	$1,471.96	$1,994.45
Sentara Facility/Professional Facility Modifier Low / Median / High Price $834.15 / $1,070.77 / $9,929.00	Facility		$834.15	$1,070.77	$9,929.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $834.15 / $1,070.77 / $9,929.00	Professional		$834.15	$1,070.77	$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 $691.20 / $930.47 / $1,599.52	Professional		$691.20	$930.47	$1,599.52