Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,258.93 / $1,819.70	Professional		$912.01	$1,258.93	$1,819.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,570.40	Facility		$2,398.83	$2,398.83	$2,570.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $2,691.53	Professional		$1,288.25	$1,288.25	$2,691.53
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,659.59	Professional		$1,288.25	$1,288.25	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,621.81 / $1,621.81	Facility		$1,047.13	$1,621.81	$1,621.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,621.81	Professional		$1,174.90	$1,174.90	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,398.83 / $3,388.44	Professional		$1,698.24	$2,398.83	$3,388.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,584.89 / $2,398.83	Professional		$1,380.38	$1,584.89	$2,398.83
Medcost Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,737.80 / $2,951.21	Facility		$912.01	$1,737.80	$2,951.21
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,318.26 / $1,584.89	Professional		$1,230.27	$1,318.26	$1,584.89
Sentara Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,995.26 / $5,011.87	Facility		$1,318.26	$1,995.26	$5,011.87
Sentara Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,995.26 / $5,011.87	Professional		$1,318.26	$1,995.26	$5,011.87
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,584.89 / $2,818.38	Facility		$794.33	$1,584.89	$2,818.38
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,174.90 / $1,778.28	Professional		$1,047.13	$1,174.90	$1,778.28