Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.95 / $218.78	Professional		$19.05	$19.95	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $199.53 / $346.74	Professional		$100.00	$199.53	$346.74
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $39.81	Professional		$30.20	$30.20	$39.81