Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $83.18	Professional		$52.48	$66.07	$83.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $208.93 / $316.23	Professional		$158.49	$208.93	$316.23
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 / $30.20	Professional		$30.20	$30.20	$30.20