Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $309.03	Facility		$41.69	$41.69	$309.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $346.74 / $363.08 / $501.19	Professional	AA	$346.74	$363.08	$501.19
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $173.78 / $295.12 / $416.87	Professional	QX	$173.78	$295.12	$416.87
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $245.47 / $275.42 / $331.13	Professional	QY	$245.47	$275.42	$331.13
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $125.89 / $371.54 / $776.25	Professional	QZ	$125.89	$371.54	$776.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $29.51 / $93.33 / $309.03	Professional	AA	$29.51	$93.33	$309.03
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $50.12 / $69.18 / $177.83	Professional	QX	$50.12	$69.18	$177.83
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	QY	$60.26	$60.26	$60.26
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $109.65 / $186.21 / $407.38	Professional	QZ	$109.65	$186.21	$407.38
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	AA	$354.81	$354.81	$354.81
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	QX	$204.17	$204.17	$204.17
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $295.12 / $354.81 / $501.19	Professional	QZ	$295.12	$354.81	$501.19