Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.85 / $4,782.00 / $8,920.00	Facility		$185.85	$4,782.00	$8,920.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $1,541.82 / $2,229.61	Professional		$158.83	$1,541.82	$2,229.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,096.94 / $2,096.94 / $2,096.94	Professional	50	$2,096.94	$2,096.94	$2,096.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,955.00 / $11,210.00 / $17,424.00	Facility		$8,955.00	$11,210.00	$17,424.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.41 / $852.32 / $2,242.38	Professional		$155.41	$852.32	$2,242.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $233.14 / $1,278.48 / $3,363.58	Professional	50	$233.14	$1,278.48	$3,363.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $165.72 / $241.44 / $9,211.00	Professional		$165.72	$241.44	$9,211.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.50 / $493.60 / $3,545.74	Professional		$183.50	$493.60	$3,545.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,496.24 / $1,802.02 / $2,252.53	Professional		$1,496.24	$1,802.02	$2,252.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $179.99 / $1,802.02 / $3,420.73	Facility		$179.99	$1,802.02	$3,420.73
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $420.79 / $4,098.47 / $5,715.65	Facility	50	$420.79	$4,098.47	$5,715.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,111.19 / $2,687.00 / $4,981.00	Professional		$2,111.19	$2,687.00	$4,981.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $170.08 / $222.79 / $5,122.00	Facility		$170.08	$222.79	$5,122.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,986.70 / $2,603.51 / $6,246.00	Professional		$1,986.70	$2,603.51	$6,246.00
United Facility/Professional Facility Modifier Low / Median / High Price $6,303.00 / $9,373.00 / $17,192.00	Facility		$6,303.00	$9,373.00	$17,192.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,689.50 / $2,694.74 / $4,079.20	Professional		$1,689.50	$2,694.74	$4,079.20