Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.55 / $5,087.00 / $8,920.00	Facility		$159.55	$5,087.00	$8,920.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.81 / $152.81 / $1,700.00	Facility		$152.81	$152.81	$1,700.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $14.95 / $14.95 / $14.95	Facility	AS	$14.95	$14.95	$14.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.21 / $158.99 / $186.15	Professional		$124.21	$158.99	$186.15
Medcost Facility/Professional Facility Modifier Low / Median / High Price $142.84 / $186.67 / $271.24	Facility		$142.84	$186.67	$271.24
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $24.90 / $30.10 / $51.15	Facility	AS	$24.90	$30.10	$51.15
Sentara Facility/Professional Facility Modifier Low / Median / High Price $132.38 / $187.47 / $677.68	Facility		$132.38	$187.47	$677.68
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