Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility		$2,884.03	$2,884.03	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,691.53 / $3,715.35	Professional		$1,905.46	$2,691.53	$3,715.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $5,623.41 / $5,888.44	Facility		$5,623.41	$5,623.41	$5,888.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $5,623.41	Professional		$2,691.53	$2,691.53	$5,623.41
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $3,801.89	Professional		$2,951.21	$2,951.21	$3,801.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,290.87 / $3,548.13 / $3,548.13	Facility		$2,290.87	$3,548.13	$3,548.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $3,548.13	Professional		$2,570.40	$2,570.40	$3,548.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $5,623.41 / $7,762.47	Professional		$3,890.45	$5,623.41	$7,762.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $3,630.78 / $5,495.41	Professional		$2,187.76	$3,630.78	$5,495.41
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,630.78 / $6,456.54	Facility		$1,905.46	$3,630.78	$6,456.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,019.95 / $3,630.78	Professional		$2,951.21	$3,019.95	$3,630.78
Sentara Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,570.88 / $10,000.00	Facility		$3,019.95	$4,570.88	$10,000.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $4,570.88 / $10,000.00	Professional		$3,019.95	$4,570.88	$10,000.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $3,311.31 / $5,888.44	Facility		$1,659.59	$3,311.31	$5,888.44
United Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,691.53 / $4,073.80	Professional		$2,187.76	$2,691.53	$4,073.80