Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.88 / $3,633.00 / $8,920.00	Facility		$104.88	$3,633.00	$8,920.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.88 / $133.77 / $225.78	Professional		$104.88	$133.77	$225.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $915.00 / $915.00 / $915.00	Professional	50	$915.00	$915.00	$915.00
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 $110.53 / $140.56 / $198.63	Professional		$110.53	$140.56	$198.63
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $164.14 / $210.84 / $297.95	Professional	50	$164.14	$210.84	$297.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $137.91 / $274.85 / $1,080.00	Professional		$137.91	$274.85	$1,080.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $201.77 / $201.77 / $201.77	Facility		$201.77	$201.77	$201.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.30 / $154.10 / $299.64	Professional		$109.30	$154.10	$299.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $126.04 / $148.28 / $188.82	Professional		$126.04	$148.28	$188.82
Medcost Facility/Professional Facility Modifier Low / Median / High Price $104.88 / $151.54 / $237.69	Facility		$104.88	$151.54	$237.69
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $144.00 / $257.29 / $555.38	Facility	50	$144.00	$257.29	$555.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $158.00 / $179.00 / $256.01	Professional		$158.00	$179.00	$256.01
Sentara Facility/Professional Facility Modifier Low / Median / High Price $107.36 / $149.61 / $1,380.00	Facility		$107.36	$149.61	$1,380.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $170.06 / $1,380.00	Professional		$125.70	$170.06	$1,380.00
United Facility/Professional Facility Modifier Low / Median / High Price $231.00 / $833.00 / $2,375.00	Facility		$231.00	$833.00	$2,375.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.07 / $127.50 / $224.18	Professional		$92.07	$127.50	$224.18