Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $741.31 / $851.14 / $1,000.00	Facility	QK	$741.31	$851.14	$1,000.00
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $575.44 / $851.14 / $4,677.35	Facility	QX	$575.44	$851.14	$4,677.35
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $575.44 / $1,288.25 / $2,754.23	Facility	QZ	$575.44	$1,288.25	$2,754.23
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90