Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,882.66 / $3,742.72 / $6,213.49	Facility		$1,882.66	$3,742.72	$6,213.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,882.66 / $2,058.37 / $2,133.67	Professional		$1,882.66	$2,058.37	$2,133.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,533.78 / $12,224.72 / $15,437.79	Facility		$9,533.78	$12,224.72	$15,437.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.00 / $304.00 / $515.88	Professional		$304.00	$304.00	$515.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $2,008.17 / $2,334.50 / $4,552.27	Professional		$2,008.17	$2,334.50	$4,552.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,631.64 / $5,533.16 / $12,859.28	Facility		$1,631.64	$5,533.16	$12,859.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,776.14 / $2,776.14 / $3,326.13	Professional		$2,776.14	$2,776.14	$3,326.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,510.21 / $3,012.25 / $3,715.11	Professional		$2,510.21	$3,012.25	$3,715.11
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,995.62 / $2,510.21 / $3,904.63	Facility		$1,995.62	$2,510.21	$3,904.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $3,439.00 / $4,970.22 / $6,024.50	Professional		$3,439.00	$4,970.22	$6,024.50
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,754.64 / $2,716.05 / $4,660.46	Facility		$1,754.64	$2,716.05	$4,660.46
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,757.15 / $2,785.83 / $4,660.46	Professional		$1,757.15	$2,785.83	$4,660.46
United Facility/Professional Professional Modifier Low / Median / High Price $1,054.29 / $1,255.10 / $2,886.74	Professional		$1,054.29	$1,255.10	$2,886.74