Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $330.00 / $330.00	Facility		$35.00	$330.00	$330.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $39.18 / $610.54 / $610.54	Professional	AA	$39.18	$610.54	$610.54
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $14.51 / $220.50 / $302.60	Professional	QK	$14.51	$220.50	$302.60
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $152.50 / $218.05 / $315.00	Professional	QX	$152.50	$218.05	$315.00
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $218.05 / $218.05 / $218.05	Professional	QY	$218.05	$218.05	$218.05
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $126.13 / $610.54 / $784.98	Professional	QZ	$126.13	$610.54	$784.98
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $411.42 / $485.10 / $514.28	Professional	AA	$411.42	$485.10	$514.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.50 / $1,230.38 / $1,463.44	Facility		$84.50	$1,230.38	$1,463.44
Wellmark Facility/Professional Professional Modifier AA Low / Median / High Price $444.00 / $444.00 / $444.00	Professional	AA	$444.00	$444.00	$444.00
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $199.50 / $222.00 / $246.00	Professional	QX	$199.50	$222.00	$246.00
Wellmark Facility/Professional Professional Modifier QZ Low / Median / High Price $346.20 / $346.20 / $346.20	Professional	QZ	$346.20	$346.20	$346.20