Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,942.01 / $5,412.00 / $11,425.00	Facility		$1,942.01	$5,412.00	$11,425.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,354.63 / $1,862.95 / $2,472.73	Professional		$1,354.63	$1,862.95	$2,472.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,142.00 / $20,977.18 / $29,216.95	Facility		$7,142.00	$20,977.18	$29,216.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,634.11 / $2,114.34 / $3,495.63	Professional		$1,634.11	$2,114.34	$3,495.63
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $916.00 / $1,648.31 / $3,115.31	Professional		$916.00	$1,648.31	$3,115.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $2,012.44	Facility		$640.00	$640.00	$2,012.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,512.97 / $1,996.61 / $3,790.65	Professional		$1,512.97	$1,996.61	$3,790.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,681.08 / $2,175.51 / $2,571.06	Professional		$1,681.08	$2,175.51	$2,571.06
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,701.84 / $2,179.65 / $3,368.58	Facility		$1,701.84	$2,179.65	$3,368.58
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,864.54 / $2,131.00 / $3,235.00	Professional		$1,864.54	$2,131.00	$3,235.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,549.74 / $2,074.53 / $7,378.46	Facility		$1,549.74	$2,074.53	$7,378.46
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,549.74 / $2,074.53 / $7,378.46	Professional		$1,549.74	$2,074.53	$7,378.46
United Facility/Professional Facility Modifier Low / Median / High Price $7,408.00 / $13,296.00 / $26,537.00	Facility		$7,408.00	$13,296.00	$26,537.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,200.70 / $1,938.00 / $3,263.74	Professional		$1,200.70	$1,938.00	$3,263.74