Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $501.19 / $831.76 / $1,412.54	Professional	AA	$501.19	$831.76	$1,412.54
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $109.65 / $338.84 / $489.78	Professional	QX	$109.65	$338.84	$489.78
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $223.87 / $436.52 / $724.44	Professional	QY	$223.87	$436.52	$724.44
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $630.96 / $933.25 / $1,288.25	Professional	QZ	$630.96	$933.25	$1,288.25
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $416.87 / $478.63 / $524.81	Professional	AA	$416.87	$478.63	$524.81
Wellmark Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	AA	$446.68	$446.68	$446.68
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $245.47 / $245.47	Professional	QX	$199.53	$245.47	$245.47
Wellmark Facility/Professional Professional Modifier QZ Low / Median / High Price $346.74 / $346.74 / $346.74	Professional	QZ	$346.74	$346.74	$346.74