Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.72 / $490.48 / $643.84	Facility		$28.72	$490.48	$643.84
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $451.44 / $703.25 / $975.80	Facility	QX	$451.44	$703.25	$975.80
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,356.00 / $1,609.97 / $2,386.80	Facility	QZ	$1,356.00	$1,609.97	$2,386.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $224.84 / $428.40 / $696.00	Professional		$224.84	$428.40	$696.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00