Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.00 / $109.00 / $109.00	Facility		$109.00	$109.00	$109.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $18,170.00 / $40,290.00	Facility		$193.25	$18,170.00	$40,290.00