Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $368.94 / $368.94 / $492.00	Facility		$368.94	$368.94	$492.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $41.00 / $714.00	Professional		$30.00	$41.00	$714.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $759.00 / $869.00 / $1,260.00	Professional	AA	$759.00	$869.00	$1,260.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $335.50 / $410.55 / $429.00	Professional	QX	$335.50	$410.55	$429.00
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $410.55 / $410.55 / $410.55	Professional	QY	$410.55	$410.55	$410.55
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $142.21 / $816.50 / $987.70	Professional	QZ	$142.21	$816.50	$987.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $360.00 / $471.05	Professional		$250.00	$360.00	$471.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $270.00 / $390.00 / $498.00	Professional		$270.00	$390.00	$498.00
United Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $60.00 / $92.70	Professional		$46.00	$60.00	$92.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $103.38 / $103.38 / $150.00	Professional		$103.38	$103.38	$150.00