Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $444.02 / $2,516.00 / $8,294.00	Facility		$444.02	$2,516.00	$8,294.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $444.46 / $444.46 / $640.00	Facility		$444.46	$444.46	$640.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $272.63 / $272.63 / $272.63	Facility	62	$272.63	$272.63	$272.63
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	AS	$43.62	$43.62	$43.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $362.72 / $466.13 / $550.88	Professional		$362.72	$466.13	$550.88
Medcost Facility/Professional Facility Modifier Low / Median / High Price $401.03 / $524.75 / $785.20	Facility		$401.03	$524.75	$785.20
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $98.60 / $133.40 / $202.90	Facility	80	$98.60	$133.40	$202.90
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $69.02 / $93.38 / $142.03	Facility	AS	$69.02	$93.38	$142.03
Sentara Facility/Professional Facility Modifier Low / Median / High Price $381.52 / $517.95 / $958.73	Facility		$381.52	$517.95	$958.73
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