Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $610.00 / $610.00	Facility		$30.00	$610.00	$610.00
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $98.70 / $208.37 / $287.27	Facility	QX	$98.70	$208.37	$287.27
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $135.44 / $690.10 / $850.37	Professional	AA	$135.44	$690.10	$850.37
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $52.02 / $359.31 / $560.50	Professional	QX	$52.02	$359.31	$560.50
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $295.00 / $353.32 / $419.20	Professional	QY	$295.00	$353.32	$419.20
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $444.00 / $518.00 / $518.00	Professional	AA	$444.00	$518.00	$518.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $169.75 / $199.98 / $353.50	Professional	QX	$169.75	$199.98	$353.50
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $242.94 / $242.94 / $242.94	Professional	QY	$242.94	$242.94	$242.94
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.78 / $117.78 / $700.00	Professional	QZ	$117.78	$117.78	$700.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,740.00 / $1,950.00 / $3,990.00	Facility		$1,740.00	$1,950.00	$3,990.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50