Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $440.57 / $2,701.61 / $8,920.00	Facility		$440.57	$2,701.61	$8,920.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $293.27 / $293.27 / $640.00	Facility		$293.27	$293.27	$640.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $179.89 / $179.89 / $179.89	Facility	62	$179.89	$179.89	$179.89
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $28.78 / $28.78 / $28.78	Facility	AS	$28.78	$28.78	$28.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.64 / $307.97 / $354.67	Professional		$239.64	$307.97	$354.67
Medcost Facility/Professional Facility Modifier Low / Median / High Price $242.93 / $329.68 / $479.42	Facility		$242.93	$329.68	$479.42
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $66.25 / $68.78 / $148.60	Facility	80	$66.25	$68.78	$148.60
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $46.38 / $48.15 / $104.02	Facility	AS	$46.38	$48.15	$104.02
Sentara Facility/Professional Facility Modifier Low / Median / High Price $258.75 / $338.96 / $819.00	Facility		$258.75	$338.96	$819.00
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