Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $3,647.90 / $5,872.50	Facility		$1,730.32	$3,647.90	$5,872.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,730.31 / $1,816.84 / $2,280.80	Professional		$1,730.31	$1,816.84	$2,280.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $3,650.98 / $5,883.09	Facility		$1,730.32	$3,650.98	$5,883.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $1,730.32	Professional		$1,730.32	$1,730.32	$1,730.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $2,289.81 / $2,605.65 / $3,932.16	Professional		$2,289.81	$2,605.65	$3,932.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,632.38 / $1,632.38 / $1,730.32	Facility		$1,632.38	$1,632.38	$1,730.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $1,730.32	Professional		$1,730.32	$1,730.32	$1,730.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,470.77 / $2,076.38 / $2,154.50	Professional		$1,470.77	$2,076.38	$2,154.50
Medcost Facility/Professional Facility Modifier Low / Median / High Price $309.00 / $1,866.11 / $2,280.81	Facility		$309.00	$1,866.11	$2,280.81
Medcost Facility/Professional Professional Modifier Low / Median / High Price $803.00 / $803.00 / $803.00	Professional		$803.00	$803.00	$803.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,643.80 / $1,731.23 / $2,214.81	Facility		$1,643.80	$1,731.23	$2,214.81
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,643.80 / $1,731.23 / $2,214.81	Professional		$1,643.80	$1,731.23	$2,214.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,670.30 / $1,670.30 / $1,670.30	Facility		$1,670.30	$1,670.30	$1,670.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,834.14 / $2,154.50	Professional		$1,730.32	$1,834.14	$2,154.50