Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.85 / $2,582.00 / $8,294.00	Facility		$127.85	$2,582.00	$8,294.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.88 / $149.66 / $323.52	Professional		$101.88	$149.66	$323.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $174.69 / $281.73 / $1,218.00	Professional	50	$174.69	$281.73	$1,218.00
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 $107.25 / $137.16 / $190.46	Professional		$107.25	$137.16	$190.46
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $160.88 / $205.74 / $285.69	Professional	50	$160.88	$205.74	$285.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $132.08 / $269.12 / $1,013.00	Professional		$132.08	$269.12	$1,013.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.65 / $192.65 / $192.65	Facility		$192.65	$192.65	$192.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.11 / $164.30 / $269.07	Professional		$111.11	$164.30	$269.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.32 / $159.19 / $202.54	Professional		$135.32	$159.19	$202.54
Medcost Facility/Professional Facility Modifier Low / Median / High Price $110.81 / $158.66 / $256.36	Facility		$110.81	$158.66	$256.36
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $144.00 / $256.85 / $617.63	Facility	50	$144.00	$256.85	$617.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $182.00 / $203.00 / $274.92	Professional		$182.00	$203.00	$274.92
Sentara Facility/Professional Facility Modifier Low / Median / High Price $104.28 / $143.94 / $1,380.00	Facility		$104.28	$143.94	$1,380.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $135.51 / $182.42 / $1,380.00	Professional		$135.51	$182.42	$1,380.00
United Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $1,045.00 / $2,364.00	Facility		$296.00	$1,045.00	$2,364.00
United Facility/Professional Professional Modifier Low / Median / High Price $105.66 / $150.38 / $271.44	Professional		$105.66	$150.38	$271.44