Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $275.00 / $1,067.22	Facility		$35.00	$275.00	$1,067.22
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $48.00 / $198.94 / $235.41	Professional	AA	$48.00	$198.94	$235.41
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $189.00 / $226.95 / $264.77	Professional	QK	$189.00	$226.95	$264.77
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $145.75 / $189.00 / $266.75	Professional	QX	$145.75	$189.00	$266.75
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 $378.00 / $593.63 / $617.40	Professional	QZ	$378.00	$593.63	$617.40
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $274.27 / $323.39 / $342.85	Professional	AA	$274.27	$323.39	$342.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.97 / $1,051.18 / $1,484.96	Facility		$52.97	$1,051.18	$1,484.96
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