Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,904.75 / $7,350.95 / $13,865.30	Facility		$2,904.75	$7,350.95	$13,865.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,904.75 / $3,175.86 / $3,292.05	Professional		$2,904.75	$3,175.86	$3,292.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,873.00 / $3,873.00 / $19,035.80	Facility		$3,873.00	$3,873.00	$19,035.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,549.20 / $1,549.20 / $2,517.44	Professional		$1,549.20	$1,549.20	$2,517.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $3,098.40 / $3,098.40 / $6,041.88	Professional		$3,098.40	$3,098.40	$6,041.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,517.44 / $7,236.97 / $19,840.81	Facility		$2,517.44	$7,236.97	$19,840.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,825.63 / $2,350.89 / $6,301.18	Professional		$1,825.63	$2,350.89	$6,301.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,873.00 / $4,647.60 / $5,732.04	Professional		$3,873.00	$4,647.60	$5,732.04
Medcost Facility/Professional Facility Modifier Low / Median / High Price $3,224.27 / $4,453.95 / $6,661.56	Facility		$3,224.27	$4,453.95	$6,661.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $3,811.00 / $5,306.00 / $9,295.20	Professional		$3,811.00	$5,306.00	$9,295.20
Sentara Facility/Professional Facility Modifier Low / Median / High Price $3,175.86 / $4,298.26 / $9,929.00	Facility		$3,175.86	$4,298.26	$9,929.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $3,175.86 / $4,337.76 / $9,929.00	Professional		$3,175.86	$4,337.76	$9,929.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,647.60 / $4,647.60 / $4,647.60	Facility		$4,647.60	$4,647.60	$4,647.60
United Facility/Professional Professional Modifier Low / Median / High Price $1,626.66 / $2,013.96 / $4,453.95	Professional		$1,626.66	$2,013.96	$4,453.95