Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $11,481.54 / $30,199.52	Facility		$2,630.27	$11,481.54	$30,199.52
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,265.80 / $13,182.57 / $21,877.62	Facility	50	$4,265.80	$13,182.57	$21,877.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,659.59 / $5,754.40	Professional		$794.33	$1,659.59	$5,754.40
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $165.96 / $331.13 / $891.25	Professional	AS	$165.96	$331.13	$891.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26,915.35 / $30,199.52 / $30,199.52	Facility		$26,915.35	$30,199.52	$30,199.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,862.09 / $3,162.28	Professional		$1,288.25	$1,862.09	$3,162.28
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $177.83 / $263.03 / $446.68	Professional	AS	$177.83	$263.03	$446.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,949.84 / $12,022.64	Professional		$1,380.38	$1,949.84	$12,022.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,819.70 / $2,754.23	Professional		$1,258.93	$1,819.70	$2,754.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,412.54 / $1,659.59	Professional		$1,122.02	$1,412.54	$1,659.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,570.40 / $2,951.21	Professional		$2,041.74	$2,570.40	$2,951.21
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,819.70 / $2,951.21	Facility		$1,230.27	$1,819.70	$2,951.21
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,819.70 / $23,988.33	Facility		$1,258.93	$1,819.70	$23,988.33
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,819.70 / $23,988.33	Professional		$1,258.93	$1,819.70	$23,988.33
United Facility/Professional Facility Modifier Low / Median / High Price $10,964.78 / $26,915.35 / $41,686.94	Facility		$10,964.78	$26,915.35	$41,686.94
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,659.59 / $2,691.53	Professional		$1,047.13	$1,659.59	$2,691.53