Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.44 / $3,633.00 / $8,294.00	Facility		$133.44	$3,633.00	$8,294.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $412.89 / $412.89 / $604.16	Facility	50	$412.89	$412.89	$604.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.95 / $187.03 / $327.06	Professional		$114.95	$187.03	$327.06
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 $120.53 / $183.10 / $273.39	Professional		$120.53	$183.10	$273.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $180.80 / $274.66 / $410.10	Professional	50	$180.80	$274.66	$410.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $138.86 / $206.71 / $974.00	Professional		$138.86	$206.71	$974.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.91 / $207.02 / $351.43	Professional		$129.91	$207.02	$351.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.07 / $217.28 / $267.98	Professional		$181.07	$217.28	$267.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $133.44 / $216.67 / $342.51	Facility		$133.44	$216.67	$342.51
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $268.04 / $355.27 / $555.24	Facility	50	$268.04	$355.27	$555.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $232.00 / $268.00 / $393.00	Professional		$232.00	$268.00	$393.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $119.78 / $158.35 / $819.00	Facility		$119.78	$158.35	$819.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $173.45 / $249.30 / $819.00	Professional		$173.45	$249.30	$819.00
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 $151.81 / $244.79 / $387.47	Professional		$151.81	$244.79	$387.47