Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,316.25 / $4,265.68 / $6,616.35	Facility		$1,316.25	$4,265.68	$6,616.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,316.25 / $1,316.25 / $1,599.00	Professional		$1,316.25	$1,316.25	$1,599.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $1,950.00 / $8,625.83	Facility		$1,950.00	$1,950.00	$8,625.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.33 / $325.33 / $543.10	Professional		$325.33	$325.33	$543.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,560.00 / $1,560.00 / $3,042.00	Professional		$1,560.00	$1,560.00	$3,042.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,267.50 / $3,279.34 / $9,354.15	Facility		$1,267.50	$3,279.34	$9,354.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,374.96 / $2,374.96 / $2,845.47	Professional		$2,374.96	$2,374.96	$2,845.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,950.00 / $2,340.00 / $2,886.00	Professional		$1,950.00	$2,340.00	$2,886.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,395.23 / $1,950.00 / $3,268.72	Facility		$1,395.23	$1,950.00	$3,268.72
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,301.00 / $3,861.00 / $4,680.00	Professional		$2,301.00	$3,861.00	$4,680.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,267.50 / $2,242.50 / $3,620.37	Facility		$1,267.50	$2,242.50	$3,620.37
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,228.50 / $2,217.15 / $3,972.15	Professional		$1,228.50	$2,217.15	$3,972.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,170.00 / $1,950.00 / $2,340.00	Facility		$1,170.00	$1,950.00	$2,340.00
United Facility/Professional Professional Modifier Low / Median / High Price $737.10 / $912.60 / $2,242.50	Professional		$737.10	$912.60	$2,242.50