Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.00 / $449.92 / $603.60	Facility		$288.00	$449.92	$603.60
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $585.44 / $811.03 / $1,870.00	Professional	AA	$585.44	$811.03	$1,870.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $340.43 / $340.43 / $404.95	Professional	QK	$340.43	$340.43	$404.95
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $252.50 / $311.50 / $404.95	Professional	QX	$252.50	$311.50	$404.95
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $741.00 / $1,121.00 / $1,311.00	Professional	QZ	$741.00	$1,121.00	$1,311.00
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $548.55 / $548.55 / $685.70	Professional	AA	$548.55	$548.55	$685.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $340.00 / $400.00 / $650.90	Professional		$340.00	$400.00	$650.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.93 / $89.21 / $4,055.10	Facility		$57.93	$89.21	$4,055.10
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $259.12 / $328.00 / $328.00	Professional	QX	$259.12	$328.00	$328.00