Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $5,495.41 / $10,000.00	Facility		$1,202.26	$5,495.41	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,096.48 / $2,089.30	Professional		$954.99	$1,096.48	$2,089.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,748.98 / $14,791.08 / $15,848.93	Facility		$11,748.98	$14,791.08	$15,848.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $2,630.27	Professional		$1,047.13	$1,513.56	$2,630.27
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $14,454.40	Professional		$1,047.13	$1,621.81	$14,454.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,318.26 / $2,238.72	Professional		$1,023.29	$1,318.26	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,202.26 / $1,412.54	Professional		$933.25	$1,202.26	$1,412.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,778.28 / $2,454.71	Professional		$1,445.44	$1,778.28	$2,454.71
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,380.38 / $2,137.96	Facility		$1,000.00	$1,380.38	$2,137.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Professional		$1,621.81	$1,621.81	$1,621.81
Sentara Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,348.96 / $9,549.93	Facility		$977.24	$1,348.96	$9,549.93
Sentara Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,348.96 / $9,549.93	Professional		$977.24	$1,348.96	$9,549.93
United Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $11,481.54 / $23,988.33	Facility		$6,456.54	$11,481.54	$23,988.33
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,230.27 / $2,137.96	Professional		$812.83	$1,230.27	$2,137.96