Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $4,786.30 / $10,000.00	Facility		$302.00	$4,786.30	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $2,951.21 / $4,265.80	Professional		$251.19	$2,951.21	$4,265.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Professional	50	$9,332.54	$9,332.54	$9,332.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,772.37 / $12,302.69 / $17,782.79	Facility		$9,772.37	$12,302.69	$17,782.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $2,454.71 / $4,897.79	Professional		$269.15	$2,454.71	$4,897.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $407.38 / $3,715.35 / $7,413.10	Professional	50	$407.38	$3,715.35	$7,413.10
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $38.02 / $346.74 / $691.83	Professional	AS	$38.02	$346.74	$691.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $10,000.00	Professional		$263.03	$398.11	$10,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $2,454.71 / $6,165.95	Professional		$281.84	$2,454.71	$6,165.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $3,467.37 / $4,365.16	Professional		$208.93	$3,467.37	$4,365.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $8,709.64 / $8,709.64 / $8,709.64	Professional		$8,709.64	$8,709.64	$8,709.64
Medcost Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $2,884.03 / $6,606.93	Facility		$288.40	$2,884.03	$6,606.93
Sentara Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $346.74 / $10,000.00	Facility		$245.47	$346.74	$10,000.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $5,011.87 / $10,964.78	Professional		$3,388.44	$5,011.87	$10,964.78
United Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $9,549.93 / $19,054.61	Facility		$5,623.41	$9,549.93	$19,054.61
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $2,187.76 / $6,760.83	Professional		$223.87	$2,187.76	$6,760.83