Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,812.50 / $7,117.50 / $13,425.00	Facility		$2,812.50	$7,117.50	$13,425.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,812.50 / $3,075.00 / $3,187.50	Professional		$2,812.50	$3,075.00	$3,187.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,750.00 / $3,750.00 / $18,431.25	Facility		$3,750.00	$3,750.00	$18,431.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $1,500.00 / $2,437.50	Professional		$1,500.00	$1,500.00	$2,437.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $3,000.00 / $3,000.00 / $5,850.00	Professional		$3,000.00	$3,000.00	$5,850.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,437.50 / $6,979.42 / $19,210.08	Facility		$2,437.50	$6,979.42	$19,210.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,848.69 / $2,276.21 / $6,189.51	Professional		$1,848.69	$2,276.21	$6,189.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $4,500.00 / $5,550.00	Professional		$3,750.00	$4,500.00	$5,550.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $2,920.30 / $4,125.00 / $5,833.13	Facility		$2,920.30	$4,125.00	$5,833.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $3,592.00 / $3,898.08 / $8,855.62	Professional		$3,592.00	$3,898.08	$8,855.62
Sentara Facility/Professional Facility Modifier Low / Median / High Price $3,128.89 / $4,360.50 / $9,929.00	Facility		$3,128.89	$4,360.50	$9,929.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $3,159.76 / $4,452.38 / $9,929.00	Professional		$3,159.76	$4,452.38	$9,929.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,628.27 / $3,750.00 / $4,380.45	Facility		$2,628.27	$3,750.00	$4,380.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,226.53 / $1,752.18 / $3,358.35	Professional		$1,226.53	$1,752.18	$3,358.35