Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $689.30 / $1,005.70 / $2,520.00	Professional	AA	$689.30	$1,005.70	$2,520.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $109.57 / $257.50 / $453.90	Professional	QX	$109.57	$257.50	$453.90
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $405.51 / $463.44 / $1,700.50	Professional	QZ	$405.51	$463.44	$1,700.50
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $411.42 / $411.42 / $514.28	Professional	AA	$411.42	$411.42	$514.28
United Facility/Professional Professional Modifier QY Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	QY	$80.00	$80.00	$80.00
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $194.34 / $246.00 / $246.00	Professional	QX	$194.34	$246.00	$246.00