Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $505.68 / $614.86	Facility		$48.00	$505.68	$614.86
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $84.50 / $97.50 / $136.50	Facility	QX	$84.50	$97.50	$136.50
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $482.72 / $641.07 / $773.14	Facility	QZ	$482.72	$641.07	$773.14
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $619.09 / $832.50 / $1,258.00	Professional	AA	$619.09	$832.50	$1,258.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $183.93 / $632.24 / $1,258.00	Professional	QK	$183.93	$632.24	$1,258.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $177.80 / $617.76 / $1,258.00	Professional	QX	$177.80	$617.76	$1,258.00
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $156.34 / $699.30 / $1,237.59	Professional	QY	$156.34	$699.30	$1,237.59
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $355.60 / $654.90 / $1,237.59	Professional	QZ	$355.60	$654.90	$1,237.59
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $465.43 / $465.43 / $528.90	Professional	AA	$465.43	$465.43	$528.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.98 / $156.55 / $284.26	Facility		$22.98	$156.55	$284.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $306.89 / $346.15 / $625.00	Professional		$306.89	$346.15	$625.00