Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,059.19 / $17,864.00 / $49,267.00	Facility		$2,059.19	$17,864.00	$49,267.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $178.66 / $254.99 / $565.65	Facility	53	$178.66	$254.99	$565.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $893.31 / $1,274.93 / $2,082.75	Professional		$893.31	$1,274.93	$2,082.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,931.00 / $10,276.00 / $11,063.00	Facility		$7,931.00	$10,276.00	$11,063.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $841.04 / $1,070.80 / $1,492.49	Professional		$841.04	$1,070.80	$1,492.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,290.20 / $2,515.89 / $33,893.43	Professional		$1,290.20	$2,515.89	$33,893.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22,700.00 / $35,526.00 / $46,027.00	Facility		$22,700.00	$35,526.00	$46,027.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $991.61 / $1,400.68 / $2,847.82	Professional		$991.61	$1,400.68	$2,847.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $863.97 / $1,036.76 / $1,278.68	Professional		$863.97	$1,036.76	$1,278.68
Medcost Facility/Professional Facility Modifier Low / Median / High Price $893.31 / $1,440.67 / $2,082.76	Facility		$893.31	$1,440.67	$2,082.76
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $320.83 / $320.83 / $320.83	Facility	80	$320.83	$320.83	$320.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,253.00 / $1,523.00 / $2,351.94	Professional		$1,253.00	$1,523.00	$2,351.94
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,052.18 / $1,426.05 / $19,390.00	Facility		$1,052.18	$1,426.05	$19,390.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,052.18 / $1,426.05 / $19,390.00	Professional		$1,052.18	$1,426.05	$19,390.00
United Facility/Professional Facility Modifier Low / Median / High Price $8,385.00 / $18,233.00 / $64,092.00	Facility		$8,385.00	$18,233.00	$64,092.00
United Facility/Professional Professional Modifier Low / Median / High Price $992.66 / $1,623.78 / $2,326.42	Professional		$992.66	$1,623.78	$2,326.42