Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $120.23 / $123.03	Professional		$114.82	$120.23	$123.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $275.42 / $758.58	Professional		$151.36	$275.42	$758.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $131.83 / $208.93	Facility		$114.82	$131.83	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23