Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $634.39 / $4,196.00 / $9,347.59	Facility		$634.39	$4,196.00	$9,347.59
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,579.26 / $9,735.00 / $9,735.00	Facility	50	$5,579.26	$9,735.00	$9,735.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $515.08 / $644.54 / $1,195.83	Professional		$515.08	$644.54	$1,195.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,070.82 / $5,211.51 / $5,463.86	Professional	50	$1,070.82	$5,211.51	$5,463.86
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 $543.66 / $695.22 / $965.38	Professional		$543.66	$695.22	$965.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $815.49 / $1,042.83 / $1,448.07	Professional	50	$815.49	$1,042.83	$1,448.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $632.28 / $1,237.94 / $3,472.00	Professional		$632.28	$1,237.94	$3,472.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $983.65 / $983.65 / $983.65	Facility		$983.65	$983.65	$983.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $550.07 / $796.54 / $1,338.80	Professional		$550.07	$796.54	$1,338.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $688.70 / $810.24 / $1,032.68	Professional		$688.70	$810.24	$1,032.68
Medcost Facility/Professional Facility Modifier Low / Median / High Price $563.12 / $811.46 / $1,298.99	Facility		$563.12	$811.46	$1,298.99
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,011.00 / $1,525.50 / $3,081.72	Facility	50	$1,011.00	$1,525.50	$3,081.72
Medcost Facility/Professional Professional Modifier Low / Median / High Price $883.00 / $1,012.00 / $1,389.67	Professional		$883.00	$1,012.00	$1,389.67
Sentara Facility/Professional Facility Modifier Low / Median / High Price $551.44 / $721.42 / $7,420.00	Facility		$551.44	$721.42	$7,420.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $680.73 / $890.80 / $7,420.00	Professional		$680.73	$890.80	$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 $522.45 / $711.35 / $1,175.59	Professional		$522.45	$711.35	$1,175.59