Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $344.00 / $434.80	Facility		$50.50	$344.00	$434.80
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $127.22 / $669.06 / $980.00	Professional	AA	$127.22	$669.06	$980.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $57.91 / $415.47 / $415.47	Professional	QX	$57.91	$415.47	$415.47
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $85.93 / $206.40 / $344.50	Professional	QZ	$85.93	$206.40	$344.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $498.00 / $504.00 / $541.08	Professional	AA	$498.00	$504.00	$541.08
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $119.55 / $386.40 / $386.40	Professional	QX	$119.55	$386.40	$386.40
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $101.50 / $121.80 / $581.00	Professional	QZ	$101.50	$121.80	$581.00
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 / $150.00	Professional	QY	$150.00	$150.00	$150.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $222.50 / $260.00 / $376.25	Facility		$222.50	$260.00	$376.25