Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.72 / $2,827.43 / $8,920.00	Facility		$428.72	$2,827.43	$8,920.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,776.50 / $2,776.50 / $7,757.52	Facility	50	$2,776.50	$2,776.50	$7,757.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.97 / $428.72 / $898.60	Professional		$275.97	$428.72	$898.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $654.12 / $3,609.00 / $3,789.00	Professional	50	$654.12	$3,609.00	$3,789.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,735.00 / $2,390.00 / $2,954.00	Facility		$1,735.00	$2,390.00	$2,954.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $253.49 / $414.17	Professional		$198.22	$253.49	$414.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $297.33 / $380.23 / $621.25	Professional	50	$297.33	$380.23	$621.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $232.18 / $453.28 / $2,413.00	Professional		$232.18	$453.28	$2,413.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $354.05 / $354.05 / $354.05	Facility		$354.05	$354.05	$354.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.06 / $458.73 / $903.88	Professional		$217.06	$458.73	$903.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $227.10 / $267.18 / $340.10	Professional		$227.10	$267.18	$340.10
Medcost Facility/Professional Facility Modifier Low / Median / High Price $232.99 / $506.80 / $870.00	Facility		$232.99	$506.80	$870.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $456.55 / $919.59 / $2,208.23	Facility	50	$456.55	$919.59	$2,208.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $452.00 / $661.00 / $769.36	Professional		$452.00	$661.00	$769.36
Sentara Facility/Professional Facility Modifier Low / Median / High Price $273.43 / $569.96 / $2,755.00	Facility		$273.43	$569.96	$2,755.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $298.70 / $600.92 / $2,755.00	Professional		$298.70	$600.92	$2,755.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,066.00 / $1,890.00 / $3,765.00	Facility		$1,066.00	$1,890.00	$3,765.00
United Facility/Professional Professional Modifier Low / Median / High Price $365.79 / $496.42 / $931.27	Professional		$365.79	$496.42	$931.27