Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.00 / $330.00 / $504.00	Facility		$44.00	$330.00	$504.00
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $429.00 / $505.92 / $505.92	Facility	AA	$429.00	$505.92	$505.92
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $236.79 / $236.79 / $597.60	Facility	QK	$236.79	$236.79	$597.60
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $92.12 / $99.96 / $236.79	Facility	QX	$92.12	$99.96	$236.79
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $174.70 / $174.70 / $174.70	Facility	QY	$174.70	$174.70	$174.70
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $712.95 / $814.66 / $921.08	Facility	QZ	$712.95	$814.66	$921.08
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $254.00 / $658.99 / $1,208.64	Professional	AA	$254.00	$658.99	$1,208.64
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $179.20 / $317.54 / $470.57	Professional	QK	$179.20	$317.54	$470.57
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $152.50 / $289.04 / $426.33	Professional	QX	$152.50	$289.04	$426.33
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $218.05 / $324.50 / $472.50	Professional	QY	$218.05	$324.50	$472.50
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $218.45 / $409.16 / $717.60	Professional	QZ	$218.45	$409.16	$717.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $235.00 / $453.55	Facility		$235.00	$235.00	$453.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,456.92 / $5,821.21 / $8,577.84	Facility		$5,456.92	$5,821.21	$8,577.84
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $381.06 / $387.56 / $387.56	Professional	AA	$381.06	$387.56	$387.56
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $450.00 / $463.00 / $463.00	Professional	QZ	$450.00	$463.00	$463.00
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 QK Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QK	$180.00	$180.00	$180.00
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 AA Low / Median / High Price $75.00 / $365.00 / $640.00	Professional	AA	$75.00	$365.00	$640.00
United Facility/Professional Professional Modifier QX Low / Median / High Price $80.00 / $85.00 / $85.00	Professional	QX	$80.00	$85.00	$85.00
United Facility/Professional Professional Modifier QY Low / Median / High Price $90.00 / $90.00 / $189.00	Professional	QY	$90.00	$90.00	$189.00