Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $258.75 / $775.18	Facility		$30.00	$258.75	$775.18
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $250.25 / $250.25 / $250.25	Facility	QX	$250.25	$250.25	$250.25
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $352.89 / $364.46 / $559.09	Professional	AA	$352.89	$364.46	$559.09
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $65.06 / $258.37 / $387.65	Professional	QX	$65.06	$258.37	$387.65
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $344.10 / $344.10 / $344.10	Professional	QY	$344.10	$344.10	$344.10
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $113.29 / $456.78 / $692.07	Professional	QZ	$113.29	$456.78	$692.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $210.00 / $355.00 / $450.00	Professional		$210.00	$355.00	$450.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $2,393.10 / $2,490.00 / $3,184.32	Facility		$2,393.10	$2,490.00	$3,184.32
Sentara Facility/Professional Facility Modifier Low / Median / High Price $23.60 / $64.00 / $92.88	Facility		$23.60	$64.00	$92.88