Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.81 / $33.81 / $360.50	Facility		$33.81	$33.81	$360.50
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,507.65 / $1,507.65 / $1,507.65	Professional	AA	$1,507.65	$1,507.65	$1,507.65
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $65.43 / $220.62 / $231.65	Professional	QX	$65.43	$220.62	$231.65
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $61.37 / $216.94 / $224.30	Professional	QY	$61.37	$216.94	$224.30
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.22 / $138.22 / $138.22	Professional	AA	$138.22	$138.22	$138.22
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $60.15 / $60.15 / $60.15	Professional	QY	$60.15	$60.15	$60.15
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $406.00 / $406.00 / $406.00	Professional	QZ	$406.00	$406.00	$406.00
AmeriHealth Facility/Professional Professional Modifier QX Low / Median / High Price $36.79 / $77.33 / $210.00	Professional	QX	$36.79	$77.33	$210.00
AmeriHealth Facility/Professional Professional Modifier QY Low / Median / High Price $67.67 / $67.67 / $67.67	Professional	QY	$67.67	$67.67	$67.67
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Facility		$375.00	$375.00	$375.00