Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $285.00 / $285.00 / $285.00	Professional	QZ	$285.00	$285.00	$285.00
Wellmark Facility/Professional Professional Modifier QZ Low / Median / High Price $288.50 / $288.50 / $288.50	Professional	QZ	$288.50	$288.50	$288.50