Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $758.58 / $831.76	Facility		$204.17	$758.58	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Medcost Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $263.03	Facility		$208.93	$208.93	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20