Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $174.20 / $174.20 / $174.20	Facility	QX	$174.20	$174.20	$174.20
Health Alliance Plan Facility/Professional Facility Modifier QX Low / Median / High Price $174.20 / $174.20 / $174.20	Facility	QX	$174.20	$174.20	$174.20