Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $421.52 / $1,288.16	Facility		$30.00	$421.52	$1,288.16
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $554.40 / $554.40 / $554.40	Facility	QX	$554.40	$554.40	$554.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $336.00 / $568.00 / $720.00	Professional		$336.00	$568.00	$720.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $48.03 / $2,460.00 / $3,184.32	Facility		$48.03	$2,460.00	$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