Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $881.14 / $3,633.00 / $14,187.00	Facility		$881.14	$3,633.00	$14,187.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $858.77	Facility		$640.00	$640.00	$858.77
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $526.61 / $526.61 / $526.61	Facility	62	$526.61	$526.61	$526.61
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $84.26 / $84.26 / $84.26	Facility	AS	$84.26	$84.26	$84.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $700.05 / $896.87 / $1,059.94	Professional		$700.05	$896.87	$1,059.94
Medcost Facility/Professional Facility Modifier Low / Median / High Price $776.55 / $1,020.25 / $1,585.00	Facility		$776.55	$1,020.25	$1,585.00
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $192.09 / $265.39 / $429.31	Facility	80	$192.09	$265.39	$429.31
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $134.46 / $185.77 / $300.52	Facility	AS	$134.46	$185.77	$300.52
Sentara Facility/Professional Facility Modifier Low / Median / High Price $739.76 / $982.26 / $1,662.68	Facility		$739.76	$982.26	$1,662.68
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