Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $478.63 / $707.95	Facility		$44.67	$478.63	$707.95
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $575.44 / $691.83 / $977.24	Facility	QX	$575.44	$691.83	$977.24
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,348.96 / $1,621.81 / $2,570.40	Facility	QZ	$1,348.96	$1,621.81	$2,570.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $426.58 / $660.69	Professional		$223.87	$426.58	$660.69
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00