Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	QZ	$269.15	$269.15	$269.15
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QK	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QX	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QY	$39.81	$39.81	$39.81