Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Facility		$25.12	$25.12	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Professional		$25.12	$25.12	$25.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $158.49 / $165.96	Professional		$41.69	$158.49	$165.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $42.66 / $79.43	Facility		$25.12	$42.66	$79.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $69.18	Professional		$46.77	$58.88	$69.18