Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $440.00 / $440.00	Facility		$35.00	$440.00	$440.00
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 / $373.80 / $756.50	Professional	QX	$252.50	$373.80	$756.50
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $183.18 / $1,221.08 / $1,323.00	Professional	QZ	$183.18	$1,221.08	$1,323.00
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $548.55 / $646.79 / $685.70	Professional	AA	$548.55	$646.79	$685.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.50 / $84.50 / $3,700.00	Facility		$84.50	$84.50	$3,700.00
Wellmark Facility/Professional Professional Modifier AA Low / Median / High Price $592.00 / $592.00 / $592.00	Professional	AA	$592.00	$592.00	$592.00
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $266.00 / $296.00 / $328.00	Professional	QX	$266.00	$296.00	$328.00
Wellmark Facility/Professional Professional Modifier QZ Low / Median / High Price $461.60 / $461.60 / $461.60	Professional	QZ	$461.60	$461.60	$461.60