Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $491.89 / $666.00	Facility		$48.00	$491.89	$666.00
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $97.18 / $97.18 / $278.85	Facility	QX	$97.18	$97.18	$278.85
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $767.27 / $969.92 / $969.92	Facility	QZ	$767.27	$969.92	$969.92
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $622.20 / $965.70 / $1,701.70	Professional	AA	$622.20	$965.70	$1,701.70
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $171.67 / $654.90 / $1,502.50	Professional	QK	$171.67	$654.90	$1,502.50
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $193.13 / $677.10 / $1,502.50	Professional	QX	$193.13	$677.10	$1,502.50
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $171.67 / $589.50 / $1,258.00	Professional	QY	$171.67	$589.50	$1,258.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $355.60 / $710.40 / $1,292.00	Professional	QZ	$355.60	$710.40	$1,292.00
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $698.15 / $698.15 / $793.35	Professional	AA	$698.15	$698.15	$793.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.00 / $131.25 / $463.05	Facility		$23.00	$131.25	$463.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $368.28 / $415.38 / $750.00	Professional		$368.28	$415.38	$750.00
United Facility/Professional Professional Modifier QX Low / Median / High Price $85.00 / $85.00 / $95.00	Professional	QX	$85.00	$85.00	$95.00
United Facility/Professional Professional Modifier QY Low / Median / High Price $90.00 / $90.00 / $90.00	Professional	QY	$90.00	$90.00	$90.00