Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.61 / $3,633.00 / $8,920.00	Facility		$145.61	$3,633.00	$8,920.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.60 / $133.91 / $165.17	Professional		$111.60	$133.91	$165.17
Medcost Facility/Professional Facility Modifier Low / Median / High Price $127.42 / $168.88 / $246.08	Facility		$127.42	$168.88	$246.08
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $297.89 / $321.45 / $386.66	Facility	50	$297.89	$321.45	$386.66
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $39.72 / $42.86 / $51.55	Facility	80	$39.72	$42.86	$51.55
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $27.80 / $30.00 / $36.09	Facility	AS	$27.80	$30.00	$36.09
Sentara Facility/Professional Facility Modifier Low / Median / High Price $128.85 / $172.74 / $1,169.82	Facility		$128.85	$172.74	$1,169.82
United Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $1,045.00 / $2,364.00	Facility		$296.00	$1,045.00	$2,364.00