Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $281.20 / $377.25	Facility		$180.00	$281.20	$377.25
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,643.50 / $1,643.50 / $1,643.50	Professional	AA	$1,643.50	$1,643.50	$1,643.50
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $342.85 / $342.85 / $428.56	Professional	AA	$342.85	$342.85	$428.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $212.50 / $250.00 / $406.81	Professional		$212.50	$250.00	$406.81
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 $161.94 / $205.00 / $205.00	Professional	QX	$161.94	$205.00	$205.00