Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,697.63 / $3,970.00 / $8,294.00	Facility		$1,697.63	$3,970.00	$8,294.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,209.49 / $1,518.90 / $3,015.67	Professional		$1,209.49	$1,518.90	$3,015.67
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 $1,353.20 / $1,747.30 / $2,426.03	Professional		$1,353.20	$1,747.30	$2,426.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,445.46 / $1,445.46 / $5,895.00	Professional		$1,445.46	$1,445.46	$5,895.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,686.21 / $1,686.21 / $1,686.21	Facility		$1,686.21	$1,686.21	$1,686.21
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,048.79 / $1,048.79 / $1,048.79	Facility	62	$1,048.79	$1,048.79	$1,048.79
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $161.29 / $161.29 / $161.29	Facility	AS	$161.29	$161.29	$161.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,375.91 / $1,685.91 / $2,813.88	Professional		$1,375.91	$1,685.91	$2,813.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,561.34 / $1,725.70 / $2,054.40	Professional		$1,561.34	$1,725.70	$2,054.40
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,302.01 / $1,759.14 / $2,423.46	Facility		$1,302.01	$1,759.14	$2,423.46
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $260.39 / $280.89 / $373.42	Facility	80	$260.39	$280.89	$373.42
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $182.28 / $196.63 / $261.39	Facility	AS	$182.28	$196.63	$261.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,860.00 / $2,106.00 / $3,480.29	Professional		$1,860.00	$2,106.00	$3,480.29
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,396.15 / $1,830.53 / $7,250.78	Facility		$1,396.15	$1,830.53	$7,250.78
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,426.58 / $1,914.88 / $7,250.78	Professional		$1,426.58	$1,914.88	$7,250.78
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 $1,168.80 / $1,609.60 / $2,783.00	Professional		$1,168.80	$1,609.60	$2,783.00