Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $3,740.00 / $3,740.00 / $4,488.00	Facility	AA	$3,740.00	$3,740.00	$4,488.00
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $263.73 / $263.73 / $394.46	Facility	QK	$263.73	$263.73	$394.46
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $692.72 / $698.61 / $862.71	Facility	QX	$692.72	$698.61	$862.71
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $369.38 / $369.38 / $1,166.42	Facility	QY	$369.38	$369.38	$1,166.42
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,961.60 / $1,961.60 / $1,961.60	Facility	QZ	$1,961.60	$1,961.60	$1,961.60
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $815.37 / $1,068.76 / $2,380.00	Professional	AA	$815.37	$1,068.76	$2,380.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $282.37 / $475.32 / $862.28	Professional	QX	$282.37	$475.32	$862.28
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $423.80 / $542.52 / $749.48	Professional	QY	$423.80	$542.52	$749.48
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $576.00 / $866.02 / $1,234.80	Professional	QZ	$576.00	$866.02	$1,234.80
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $411.42 / $481.02 / $517.96	Professional	AA	$411.42	$481.02	$517.96
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
United Facility/Professional Professional Modifier QY Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	QY	$80.00	$80.00	$80.00