Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $251.19 / $275.42	Facility		$34.67	$251.19	$275.42
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	QZ	$549.54	$549.54	$549.54
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $512.86 / $588.84	Professional	AA	$389.05	$512.86	$588.84
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $173.78 / $177.83 / $181.97	Professional	QX	$173.78	$177.83	$181.97
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $53.70 / $72.44 / $199.53	Professional	QY	$53.70	$72.44	$199.53
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $114.82 / $512.86 / $660.69	Professional	QZ	$114.82	$512.86	$660.69
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $398.11 / $436.52	Professional	AA	$354.81	$398.11	$436.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $3,715.35	Facility		$2,754.23	$2,754.23	$3,715.35
Wellmark Facility/Professional Professional Modifier AA Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	AA	$371.54	$371.54	$371.54
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $165.96 / $204.17 / $204.17	Professional	QX	$165.96	$204.17	$204.17
Wellmark Facility/Professional Professional Modifier QZ Low / Median / High Price $288.40 / $288.40 / $288.40	Professional	QZ	$288.40	$288.40	$288.40