Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $275.42 / $446.68	Facility		$181.97	$275.42	$446.68
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional	AA	$1,659.59	$1,659.59	$1,659.59
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $524.81 / $524.81 / $912.01	Professional	QX	$524.81	$524.81	$912.01
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $354.81 / $436.52	Professional	AA	$354.81	$354.81	$436.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $275.42 / $407.38	Professional		$213.80	$275.42	$407.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $64.57 / $4,073.80	Facility		$57.54	$64.57	$4,073.80
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $165.96 / $204.17 / $204.17	Professional	QX	$165.96	$204.17	$204.17