Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $281.20 / $377.25	Facility		$180.00	$281.20	$377.25
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $498.75 / $498.75 / $805.80	Facility	QZ	$498.75	$498.75	$805.80
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $347.58 / $556.10 / $1,400.00	Professional	AA	$347.58	$556.10	$1,400.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $172.50 / $177.50 / $189.75	Professional	QX	$172.50	$177.50	$189.75
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $126.46 / $463.44 / $741.00	Professional	QZ	$126.46	$463.44	$741.00
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $342.85 / $342.85 / $428.56	Professional	AA	$342.85	$342.85	$428.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $212.50 / $250.00 / $406.81	Professional		$212.50	$250.00	$406.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,590.00 / $3,359.94 / $4,055.10	Facility		$2,590.00	$3,359.94	$4,055.10
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $161.94 / $205.00 / $205.00	Professional	QX	$161.94	$205.00	$205.00