Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $536.45	Facility		$30.00	$30.00	$536.45
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $178.80 / $840.00 / $1,438.20	Professional	AA	$178.80	$840.00	$1,438.20
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $79.31 / $364.79 / $804.68	Professional	QX	$79.31	$364.79	$804.68
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $300.41 / $364.79 / $407.48	Professional	QY	$300.41	$364.79	$407.48
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $121.78 / $371.70 / $422.10	Professional	QZ	$121.78	$371.70	$422.10
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $142.41 / $142.41 / $174.16	Professional	AA	$142.41	$142.41	$174.16
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $83.08 / $124.61 / $541.12	Professional	QX	$83.08	$124.61	$541.12
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $74.42 / $74.42 / $96.92	Professional	QY	$74.42	$74.42	$96.92
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $98.90 / $170.11 / $255.00	Professional	QZ	$98.90	$170.11	$255.00
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $140.00 / $234.00 / $340.72	Professional	AA	$140.00	$234.00	$340.72
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $39.56 / $70.00 / $151.24	Professional	QX	$39.56	$70.00	$151.24
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $112.00 / $160.00 / $242.00	Professional	QZ	$112.00	$160.00	$242.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $2,100.00 / $3,000.00	Facility		$1,800.00	$2,100.00	$3,000.00