Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $144.54 / $537.03	Facility		$30.20	$144.54	$537.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $257.04 / $741.31 / $1,202.26	Professional	AA	$257.04	$741.31	$1,202.26
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $218.78 / $371.54 / $602.56	Professional	QK	$218.78	$371.54	$602.56
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $229.09 / $380.19 / $645.65	Professional	QX	$229.09	$380.19	$645.65
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $257.04 / $346.74 / $537.03	Professional	QY	$257.04	$346.74	$537.03
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $288.40 / $537.03 / $724.44	Professional	QZ	$288.40	$537.03	$724.44
Anthem BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $467.74 / $467.74	Professional	AA	$446.68	$467.74	$467.74
Anthem BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $467.74 / $467.74	Professional	QZ	$446.68	$467.74	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $512.86	Professional		$309.03	$426.58	$512.86
Medcost Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $2,454.71 / $4,786.30	Facility		$43.65	$2,454.71	$4,786.30
Sentara Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $64.57 / $100.00	Facility		$21.38	$64.57	$100.00