Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.89 / $240.26 / $5,282.00	Facility		$51.89	$240.26	$5,282.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $116.89 / $362.77 / $4,209.34	Facility	50	$116.89	$362.77	$4,209.34
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.43 / $26.25 / $61.62	Facility	52	$18.43	$26.25	$61.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $51.89 / $87.59	Professional		$32.86	$51.89	$87.59
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.00 / $96.00 / $133.34	Professional	50	$70.00	$96.00	$133.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.52 / $21.45 / $26.25	Professional	52	$16.52	$21.45	$26.25
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 $31.94 / $45.89 / $66.59	Professional		$31.94	$45.89	$66.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.91 / $68.84 / $99.89	Professional	50	$47.91	$68.84	$99.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.68 / $54.48 / $974.00	Professional		$35.68	$54.48	$974.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $55.70 / $91.71	Professional		$35.70	$55.70	$91.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.67 / $54.80 / $89.04	Professional		$45.67	$54.80	$89.04
Medcost Facility/Professional Facility Modifier Low / Median / High Price $36.86 / $54.89 / $85.77	Facility		$36.86	$54.89	$85.77
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $87.44 / $113.81 / $140.62	Facility	50	$87.44	$113.81	$140.62
Medcost Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $69.00 / $101.15	Professional		$60.00	$69.00	$101.15
Sentara Facility/Professional Facility Modifier Low / Median / High Price $33.24 / $44.23 / $805.00	Facility		$33.24	$44.23	$805.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $47.41 / $63.65 / $805.00	Professional		$47.41	$63.65	$805.00
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 $39.08 / $67.00 / $104.77	Professional		$39.08	$67.00	$104.77