Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $306.55 / $402.40	Facility		$45.00	$306.55	$402.40
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $188.02 / $386.25 / $840.00	Professional	AA	$188.02	$386.25	$840.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $156.34 / $281.25 / $478.14	Professional	QX	$156.34	$281.25	$478.14
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $73.54 / $156.34 / $303.75	Professional	QY	$73.54	$156.34	$303.75
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $309.56 / $398.85 / $836.00	Professional	QZ	$309.56	$398.85	$836.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $116.22 / $186.57 / $393.30	Professional	AA	$116.22	$186.57	$393.30
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $12.88 / $60.09 / $126.56	Professional	QX	$12.88	$60.09	$126.56
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $83.12 / $93.29 / $103.05	Professional	QY	$83.12	$93.29	$103.05
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $96.85 / $162.21 / $189.83	Professional	QZ	$96.85	$162.21	$189.83
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QY	$150.00	$150.00	$150.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $275.00 / $435.00	Professional		$142.03	$275.00	$435.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00