Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,826.25 / $2,069.75 / $5,402.05	Facility		$1,826.25	$2,069.75	$5,402.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,826.25 / $1,996.70 / $2,069.75	Professional		$1,826.25	$1,996.70	$2,069.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,248.12 / $11,858.45 / $14,975.25	Facility		$9,248.12	$11,858.45	$14,975.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $974.00 / $974.00 / $1,582.75	Professional		$974.00	$974.00	$1,582.75
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,948.00 / $1,948.00 / $3,798.60	Professional		$1,948.00	$1,948.00	$3,798.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,582.75 / $4,067.67 / $12,473.45	Facility		$1,582.75	$4,067.67	$12,473.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,965.96 / $2,965.96 / $3,553.56	Professional		$2,965.96	$2,965.96	$3,553.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,435.00 / $2,922.00 / $3,603.80	Professional		$2,435.00	$2,922.00	$3,603.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,826.25 / $2,435.00 / $4,139.50	Facility		$1,826.25	$2,435.00	$4,139.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,582.75 / $1,582.75 / $1,582.75	Professional		$1,582.75	$1,582.75	$1,582.75
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,704.50 / $2,768.60 / $4,520.82	Facility		$1,704.50	$2,768.60	$4,520.82
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,704.50 / $2,800.25 / $4,504.75	Professional		$1,704.50	$2,800.25	$4,504.75
United Facility/Professional Professional Modifier Low / Median / High Price $1,022.70 / $1,217.50 / $2,800.25	Professional		$1,022.70	$1,217.50	$2,800.25