Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $165.96 / $446.68	Facility		$30.20	$165.96	$446.68
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $316.23 / $660.69 / $1,071.52	Professional	AA	$316.23	$660.69	$1,071.52
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $204.17 / $316.23 / $537.03	Professional	QK	$204.17	$316.23	$537.03
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $331.13 / $562.34	Professional	QX	$199.53	$331.13	$562.34
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $223.87 / $302.00 / $467.74	Professional	QY	$223.87	$302.00	$467.74
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $263.03 / $524.81 / $707.95	Professional	QZ	$263.03	$524.81	$707.95
Anthem BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $467.74 / $467.74	Professional	AA	$446.68	$467.74	$467.74
Anthem BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $467.74 / $467.74	Professional	QZ	$446.68	$467.74	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $354.81 / $426.58	Professional		$257.04	$354.81	$426.58
Medcost Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $2,454.71 / $4,786.30	Facility		$43.65	$2,454.71	$4,786.30
Sentara Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $64.57 / $100.00	Facility		$21.38	$64.57	$100.00