Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.09 / $5,087.00 / $8,294.00	Facility		$118.09	$5,087.00	$8,294.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.81 / $115.81 / $640.00	Facility		$115.81	$115.81	$640.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $11.30 / $11.30 / $11.30	Facility	AS	$11.30	$11.30	$11.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.36 / $123.34 / $142.94	Professional		$96.36	$123.34	$142.94
Medcost Facility/Professional Facility Modifier Low / Median / High Price $104.94 / $144.94 / $212.50	Facility		$104.94	$144.94	$212.50
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $19.26 / $24.91 / $38.31	Facility	AS	$19.26	$24.91	$38.31
Sentara Facility/Professional Facility Modifier Low / Median / High Price $101.55 / $142.05 / $501.24	Facility		$101.55	$142.05	$501.24
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