Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,686.85 / $5,357.45 / $10,653.20	Facility		$4,686.85	$5,357.45	$10,653.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,921.20 / $4,921.20	Professional		$4,686.85	$4,921.20	$4,921.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,686.85 / $9,889.25 / $15,935.29	Facility		$4,686.85	$9,889.25	$15,935.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $4,686.85	Professional		$4,686.85	$4,686.85	$4,686.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $6,266.77 / $7,131.15 / $10,761.56	Professional		$6,266.77	$7,131.15	$10,761.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,421.56 / $4,421.56 / $4,686.85	Facility		$4,421.56	$4,421.56	$4,686.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $4,686.85	Professional		$4,686.85	$4,686.85	$4,686.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,983.82 / $5,624.22 / $7,041.97	Professional		$3,983.82	$5,624.22	$7,041.97
Medcost Facility/Professional Facility Modifier Low / Median / High Price $2,066.90 / $4,882.87 / $6,828.47	Facility		$2,066.90	$4,882.87	$6,828.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,739.00 / $2,739.00 / $2,739.00	Professional		$2,739.00	$2,739.00	$2,739.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $4,452.51 / $4,686.85 / $5,999.17	Facility		$4,452.51	$4,686.85	$5,999.17
Sentara Facility/Professional Professional Modifier Low / Median / High Price $4,452.51 / $4,686.85 / $5,999.17	Professional		$4,452.51	$4,686.85	$5,999.17
United Facility/Professional Professional Modifier Low / Median / High Price $4,547.03 / $4,686.85 / $5,882.00	Professional		$4,547.03	$4,686.85	$5,882.00