Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medcost Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $131.00 / $180.00	Professional		$131.00	$131.00	$180.00
Sentara Facility/Professional Facility Modifier Low / Median / High Price $793.00 / $793.00 / $793.00	Facility		$793.00	$793.00	$793.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $793.00 / $793.00 / $793.00	Professional		$793.00	$793.00	$793.00