Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $776.25 / $776.25	Facility		$758.58	$776.25	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $831.76 / $1,202.26	Professional		$630.96	$831.76	$1,202.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,548.82	Facility		$1,479.11	$1,479.11	$1,548.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $1,819.70	Professional		$870.96	$870.96	$1,819.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $1,000.00	Professional		$776.25	$776.25	$1,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,202.26 / $1,202.26	Facility		$724.44	$1,202.26	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $1,202.26	Professional		$870.96	$870.96	$1,202.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,479.11 / $2,041.74	Professional		$1,023.29	$1,479.11	$2,041.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $1,445.44	Professional		$954.99	$954.99	$1,445.44
Medcost Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,071.52 / $1,949.84	Facility		$630.96	$1,071.52	$1,949.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $851.14 / $954.99	Professional		$794.33	$851.14	$954.99
Sentara Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,202.26 / $3,162.28	Facility		$794.33	$1,202.26	$3,162.28
Sentara Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,202.26 / $3,162.28	Professional		$794.33	$1,202.26	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $1,071.52 / $1,949.84	Facility		$457.09	$1,071.52	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $724.44 / $1,096.48	Professional		$676.08	$724.44	$1,096.48