Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.20 / $3,991.00 / $14,187.00	Facility		$75.20	$3,991.00	$14,187.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.06 / $79.06 / $640.00	Facility		$79.06	$79.06	$640.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $7.76 / $7.76 / $7.76	Facility	AS	$7.76	$7.76	$7.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $83.20 / $96.20	Professional		$65.00	$83.20	$96.20
Medcost Facility/Professional Facility Modifier Low / Median / High Price $71.78 / $91.15 / $127.84	Facility		$71.78	$91.15	$127.84
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $136.72 / $139.69 / $262.11	Facility	50	$136.72	$139.69	$262.11
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $18.23 / $18.63 / $34.95	Facility	80	$18.23	$18.63	$34.95
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $12.76 / $13.04 / $24.46	Facility	AS	$12.76	$13.04	$24.46
Sentara Facility/Professional Facility Modifier Low / Median / High Price $68.56 / $90.92 / $370.00	Facility		$68.56	$90.92	$370.00
United Facility/Professional Facility Modifier Low / Median / High Price $231.00 / $1,045.00 / $2,364.00	Facility		$231.00	$1,045.00	$2,364.00