Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $628.00 / $628.00 / $628.00	Professional		$628.00	$628.00	$628.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $628.00 / $816.40 / $1,328.82	Facility		$628.00	$816.40	$1,328.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00