Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $281.20 / $439.42	Facility		$180.00	$281.20	$439.42
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $765.00 / $765.00 / $765.00	Facility	QZ	$765.00	$765.00	$765.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $365.90 / $516.11 / $730.30	Professional	AA	$365.90	$516.11	$730.30
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $189.00 / $220.50 / $264.77	Professional	QK	$189.00	$220.50	$264.77
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $142.50 / $177.50 / $249.20	Professional	QX	$142.50	$177.50	$249.20
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $218.05 / $252.00 / $264.77	Professional	QY	$218.05	$252.00	$264.77
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $285.00 / $442.38 / $608.00	Professional	QZ	$285.00	$442.38	$608.00
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $274.27 / $274.27 / $342.85	Professional	AA	$274.27	$274.27	$342.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $221.00 / $325.45	Professional		$170.00	$221.00	$325.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.41 / $89.21 / $4,055.10	Facility		$23.41	$89.21	$4,055.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $894.01 / $2,187.91 / $4,610.24	Facility		$894.01	$2,187.91	$4,610.24
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $194.34 / $246.00 / $246.00	Professional	QX	$194.34	$246.00	$246.00