Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.29 / $3,633.00 / $8,920.00	Facility		$67.29	$3,633.00	$8,920.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.29 / $94.90 / $167.81	Professional		$67.29	$94.90	$167.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.26 / $165.51 / $861.51	Professional	50	$109.26	$165.51	$861.51
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 $73.14 / $93.53 / $130.16	Professional		$73.14	$93.53	$130.16
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.71 / $140.29 / $194.81	Professional	50	$109.71	$140.29	$194.81
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $90.71 / $180.12 / $1,013.00	Professional		$90.71	$180.12	$1,013.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.79 / $129.79 / $129.79	Facility		$129.79	$129.79	$129.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.97 / $119.08 / $186.12	Professional		$81.97	$119.08	$186.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.01 / $105.89 / $134.06	Professional		$90.01	$105.89	$134.06
Medcost Facility/Professional Facility Modifier Low / Median / High Price $67.29 / $107.64 / $175.39	Facility		$67.29	$107.64	$175.39
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $102.00 / $206.57 / $381.90	Facility	50	$102.00	$206.57	$381.90
Medcost Facility/Professional Professional Modifier Low / Median / High Price $109.00 / $153.00 / $184.76	Professional		$109.00	$153.00	$184.76
Sentara Facility/Professional Facility Modifier Low / Median / High Price $70.30 / $120.10 / $1,380.00	Facility		$70.30	$120.10	$1,380.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $138.40 / $1,380.00	Professional		$80.43	$138.40	$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 $69.83 / $97.76 / $168.05	Professional		$69.83	$97.76	$168.05