Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $309.03 / $954.99	Facility		$125.89	$309.03	$954.99
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $79.43 / $794.33 / $977.24	Facility	25	$79.43	$794.33	$977.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $549.54	Professional		$141.25	$177.83	$549.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $218.78 / $302.00	Professional		$177.83	$218.78	$302.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $223.87 / $338.84	Facility		$151.36	$223.87	$338.84
Sentara Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $213.80 / $776.25	Facility		$151.36	$213.80	$776.25