Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $331.13 / $537.03	Facility		$213.80	$331.13	$537.03
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility	QZ	$2,290.87	$2,290.87	$2,290.87
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $851.14 / $1,380.38	Professional	AA	$446.68	$851.14	$1,380.38
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $87.10 / $398.11 / $660.69	Professional	QK	$87.10	$398.11	$660.69
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $151.36 / $407.38 / $676.08	Professional	QX	$151.36	$407.38	$676.08
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $223.87 / $346.74 / $575.44	Professional	QY	$223.87	$346.74	$575.44
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $363.08 / $588.84 / $912.01	Professional	QZ	$363.08	$588.84	$912.01
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $416.87 / $416.87 / $524.81	Professional	AA	$416.87	$416.87	$524.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $489.78	Professional		$251.19	$331.13	$489.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $89.13 / $2,570.40	Facility		$57.54	$89.13	$2,570.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $2,238.72 / $6,165.95	Facility		$851.14	$2,238.72	$6,165.95
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $245.47 / $245.47	Professional	QX	$199.53	$245.47	$245.47