Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.18 / $2,513.00 / $3,581.00	Facility		$164.18	$2,513.00	$3,581.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $520.60 / $2,513.00 / $3,723.00	Facility	25	$520.60	$2,513.00	$3,723.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $172.80 / $352.00 / $389.19	Professional	25	$172.80	$352.00	$389.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.43 / $3,485.00 / $4,795.00	Facility		$202.43	$3,485.00	$4,795.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $161.44 / $214.66 / $596.29	Professional		$161.44	$214.66	$596.29
Medcost Facility/Professional Facility Modifier Low / Median / High Price $171.20 / $216.00 / $353.00	Facility		$171.20	$216.00	$353.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $173.80 / $212.42 / $363.38	Facility		$173.80	$212.42	$363.38