Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $722.45 / $872.77 / $872.77	Facility		$722.45	$872.77	$872.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $722.45 / $872.77 / $1,231.33	Professional		$722.45	$872.77	$1,231.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,765.16 / $1,765.16 / $1,874.60	Facility		$1,765.16	$1,765.16	$1,874.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,138.79 / $1,138.79 / $1,439.05	Professional		$1,138.79	$1,138.79	$1,439.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $946.00 / $946.00 / $1,206.65	Professional		$946.00	$946.00	$1,206.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $943.55 / $1,184.20 / $1,184.20	Facility		$943.55	$1,184.20	$1,184.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $864.47 / $864.47 / $1,184.20	Professional		$864.47	$864.47	$1,184.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,235.60 / $1,588.64 / $2,118.19	Professional		$1,235.60	$1,588.64	$2,118.19
Medcost Facility/Professional Facility Modifier Low / Median / High Price $568.52 / $1,085.61 / $2,009.33	Facility		$568.52	$1,085.61	$2,009.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,101.00 / $2,206.44 / $2,940.19	Professional		$1,101.00	$2,206.44	$2,940.19
Sentara Facility/Professional Facility Modifier Low / Median / High Price $967.09 / $1,332.16 / $2,106.69	Facility		$967.09	$1,332.16	$2,106.69
Sentara Facility/Professional Professional Modifier Low / Median / High Price $967.09 / $1,332.16 / $2,106.69	Professional		$967.09	$1,332.16	$2,106.69
United Facility/Professional Professional Modifier Low / Median / High Price $795.92 / $880.62 / $1,326.54	Professional		$795.92	$880.62	$1,326.54