Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,904.75 / $5,774.64 / $13,865.30	Facility		$2,904.75	$5,774.64	$13,865.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,904.75 / $3,292.05 / $3,873.00	Professional		$2,904.75	$3,292.05	$3,873.00
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 / $6,041.88 / $15,045.45	Professional		$3,098.40	$6,041.88	$15,045.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,517.44 / $7,236.97 / $17,558.09	Facility		$2,517.44	$7,236.97	$17,558.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,909.45 / $2,350.89 / $6,392.54	Professional		$1,909.45	$2,350.89	$6,392.54
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 $3,176.73 / $4,453.95 / $6,325.93	Facility		$3,176.73	$4,453.95	$6,325.93
Medcost Facility/Professional Professional Modifier Low / Median / High Price $3,873.00 / $4,304.00 / $9,146.46	Professional		$3,873.00	$4,304.00	$9,146.46
Sentara Facility/Professional Facility Modifier Low / Median / High Price $2,985.15 / $4,337.76 / $9,929.00	Facility		$2,985.15	$4,337.76	$9,929.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $2,985.15 / $4,337.76 / $9,929.00	Professional		$2,985.15	$4,337.76	$9,929.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,049.50 / $3,873.00 / $4,103.30	Facility		$2,049.50	$3,873.00	$4,103.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,626.66 / $2,059.69 / $5,034.89	Professional		$1,626.66	$2,059.69	$5,034.89