Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $289.80 / $431.75	Facility		$30.00	$289.80	$431.75
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $218.30 / $218.30 / $218.30	Professional	QY	$218.30	$218.30	$218.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $355.00 / $450.00	Professional		$5.00	$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