Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $288.40 / $524.81	Facility		$181.97	$288.40	$524.81
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility	QZ	$1,445.44	$1,445.44	$1,445.44
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $831.76 / $1,202.26	Professional	AA	$354.81	$831.76	$1,202.26
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $79.43 / $338.84 / $602.56	Professional	QK	$79.43	$338.84	$602.56
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $151.36 / $346.74 / $630.96	Professional	QX	$151.36	$346.74	$630.96
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $245.47 / $295.12 / $478.63	Professional	QY	$245.47	$295.12	$478.63
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $323.59 / $575.44 / $912.01	Professional	QZ	$323.59	$575.44	$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
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $6,025.60 / $7,943.28	Facility		$1,148.15	$6,025.60	$7,943.28
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $245.47 / $245.47	Professional	QX	$199.53	$245.47	$245.47