Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $275.00 / $275.00	Facility		$35.00	$275.00	$275.00
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 $107.14 / $107.14 / $107.14	Professional	AA	$107.14	$107.14	$107.14
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $140.00 / $218.05 / $302.60	Professional	QK	$140.00	$218.05	$302.60
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $58.84 / $186.90 / $302.60	Professional	QX	$58.84	$186.90	$302.60
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $173.25 / $189.00 / $189.00	Professional	QY	$173.25	$189.00	$189.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $129.55 / $523.32 / $705.60	Professional	QZ	$129.55	$523.32	$705.60
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $342.85 / $404.25 / $428.56	Professional	AA	$342.85	$404.25	$428.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.09 / $337.77 / $1,592.57	Facility		$36.09	$337.77	$1,592.57
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