Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $275.00 / $377.25	Facility		$180.00	$275.00	$377.25
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,454.69 / $1,454.69 / $1,454.69	Facility	QZ	$1,454.69	$1,454.69	$1,454.69
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $288.00 / $516.11 / $980.00	Professional	AA	$288.00	$516.11	$980.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $140.00 / $182.50 / $264.77	Professional	QK	$140.00	$182.50	$264.77
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $53.63 / $167.50 / $218.05	Professional	QX	$53.63	$167.50	$218.05
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $173.25 / $173.25 / $189.00	Professional	QY	$173.25	$173.25	$189.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $295.00 / $523.48 / $705.60	Professional	QZ	$295.00	$523.48	$705.60
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $342.85 / $342.85 / $428.56	Professional	AA	$342.85	$342.85	$428.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $212.50 / $250.00 / $406.81	Professional		$212.50	$250.00	$406.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.93 / $89.21 / $4,055.10	Facility		$57.93	$89.21	$4,055.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,150.38 / $4,717.59 / $8,434.45	Facility		$1,150.38	$4,717.59	$8,434.45
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $194.34 / $246.00 / $246.00	Professional	QX	$194.34	$246.00	$246.00