Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $304.30 / $659.33	Facility		$30.00	$304.30	$659.33
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $329.75 / $465.08 / $753.92	Professional	AA	$329.75	$465.08	$753.92
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $220.08 / $278.22 / $343.07	Professional	QK	$220.08	$278.22	$343.07
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $216.00 / $265.76 / $343.08	Professional	QX	$216.00	$265.76	$343.08
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $237.19 / $266.83 / $618.38	Professional	QY	$237.19	$266.83	$618.38
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $440.49 / $550.62 / $647.79	Professional	QZ	$440.49	$550.62	$647.79
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 $23.08 / $64.00 / $92.88	Facility		$23.08	$64.00	$92.88