Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $389.05 / $446.68	Facility		$275.42	$389.05	$446.68
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $141.25 / $489.78 / $1,071.52	Professional	AA	$141.25	$489.78	$1,071.52
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $89.13 / $309.03 / $478.63	Professional	QX	$89.13	$309.03	$478.63
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $275.42 / $331.13	Professional	QY	$234.42	$275.42	$331.13
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $309.03 / $537.03 / $758.58	Professional	QZ	$309.03	$537.03	$758.58
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $97.72 / $229.09 / $549.54	Professional	AA	$97.72	$229.09	$549.54
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $50.12 / $81.28 / $114.82	Professional	QX	$50.12	$81.28	$114.82
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 $100.00 / $123.03 / $257.04	Professional	QZ	$100.00	$123.03	$257.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $64.57 / $194.98	Facility		$51.29	$64.57	$194.98