Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $350.00 / $350.00	Facility		$40.00	$350.00	$350.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $116.79 / $392.00 / $980.00	Professional	AA	$116.79	$392.00	$980.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $82.19 / $364.79 / $844.07	Professional	QX	$82.19	$364.79	$844.07
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 $469.20 / $567.00 / $770.00	Professional	QZ	$469.20	$567.00	$770.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $100.25 / $120.54 / $420.00	Professional	AA	$100.25	$120.54	$420.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $58.08 / $86.58 / $210.00	Professional	QX	$58.08	$86.58	$210.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $50.13 / $136.04 / $210.00	Professional	QY	$50.13	$136.04	$210.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.25 / $136.57 / $306.00	Professional	QZ	$100.25	$136.57	$306.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $300.00	Professional	QY	$150.00	$150.00	$300.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50