Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $240.00 / $431.75	Facility		$30.00	$240.00	$431.75
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $329.75 / $428.09 / $618.38	Professional	AA	$329.75	$428.09	$618.38
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $216.65 / $286.52 / $378.60	Professional	QK	$216.65	$286.52	$378.60
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $147.50 / $283.77 / $352.96	Professional	QX	$147.50	$283.77	$352.96
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $183.60 / $256.47 / $548.14	Professional	QY	$183.60	$256.47	$548.14
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $352.89 / $516.73 / $631.17	Professional	QZ	$352.89	$516.73	$631.17
Anthem BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $450.00 / $463.00 / $463.00	Professional	AA	$450.00	$463.00	$463.00
Anthem BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $450.00 / $463.00 / $463.00	Professional	QZ	$450.00	$463.00	$463.00
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 $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 $23.16 / $64.00 / $92.88	Facility		$23.16	$64.00	$92.88