Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $992.50 / $4,518.39 / $8,478.79	Facility		$992.50	$4,518.39	$8,478.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $813.62 / $1,085.55 / $1,940.19	Professional		$813.62	$1,085.55	$1,940.19
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $453.12 / $453.12 / $453.12	Professional	AS	$453.12	$453.12	$453.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,032.00 / $6,548.00 / $7,221.00	Facility		$5,032.00	$6,548.00	$7,221.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $826.69 / $1,121.85 / $1,601.11	Professional		$826.69	$1,121.85	$1,601.11
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $116.09 / $157.06 / $224.15	Professional	AS	$116.09	$157.06	$224.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $965.94 / $965.94 / $5,036.00	Professional		$965.94	$965.94	$5,036.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,467.20 / $1,467.20 / $1,467.20	Facility		$1,467.20	$1,467.20	$1,467.20
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $146.72 / $146.72 / $146.72	Facility	AS	$146.72	$146.72	$146.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $845.43 / $1,182.28 / $2,108.28	Professional		$845.43	$1,182.28	$2,108.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,134.45 / $1,262.15 / $1,502.56	Professional		$1,134.45	$1,262.15	$1,502.56
Medcost Facility/Professional Facility Modifier Low / Median / High Price $827.62 / $1,146.33 / $1,613.22	Facility		$827.62	$1,146.33	$1,613.22
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $162.87 / $203.57 / $267.93	Facility	80	$162.87	$203.57	$267.93
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $114.01 / $173.03 / $187.55	Facility	AS	$114.01	$173.03	$187.55
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,333.00 / $1,514.00 / $2,607.00	Professional		$1,333.00	$1,514.00	$2,607.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $872.63 / $1,168.55 / $7,030.19	Facility		$872.63	$1,168.55	$7,030.19
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,086.30 / $1,398.17 / $7,030.19	Professional		$1,086.30	$1,398.17	$7,030.19
United Facility/Professional Facility Modifier Low / Median / High Price $6,303.00 / $9,270.00 / $17,192.00	Facility		$6,303.00	$9,270.00	$17,192.00
United Facility/Professional Professional Modifier Low / Median / High Price $874.55 / $1,174.98 / $1,927.76	Professional		$874.55	$1,174.98	$1,927.76