Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.79 / $325.00 / $445.05	Facility		$58.79	$325.00	$445.05
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,056.00 / $1,056.00 / $1,056.00	Facility	QX	$1,056.00	$1,056.00	$1,056.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $127.56 / $514.60 / $1,263.17	Professional	AA	$127.56	$514.60	$1,263.17
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $172.80 / $210.80 / $306.89	Professional	QX	$172.80	$210.80	$306.89
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $467.99 / $580.07 / $658.36	Professional	QZ	$467.99	$580.07	$658.36
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $120.54 / $300.00 / $350.00	Professional	AA	$120.54	$300.00	$350.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $92.53 / $105.75 / $227.50	Professional	QX	$92.53	$105.75	$227.50
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $94.85 / $94.85 / $153.00	Professional	QY	$94.85	$94.85	$153.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $102.46 / $162.21 / $306.00	Professional	QZ	$102.46	$162.21	$306.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,764.00 / $2,730.00 / $3,041.64	Facility		$1,764.00	$2,730.00	$3,041.64
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $146.63 / $146.63 / $146.63	Professional	QX	$146.63	$146.63	$146.63
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $351.90 / $351.90 / $351.90	Professional	QZ	$351.90	$351.90	$351.90