Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $354.81 / $436.52	Facility		$93.33	$354.81	$436.52
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $120.23 / $660.69 / $1,023.29	Professional	AA	$120.23	$660.69	$1,023.29
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $89.13 / $331.13 / $562.34	Professional	QX	$89.13	$331.13	$562.34
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $288.40 / $446.68	Professional	QY	$234.42	$288.40	$446.68
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $85.11 / $204.17 / $346.74	Professional	QZ	$85.11	$204.17	$346.74
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $645.65 / $741.31	Professional	AA	$446.68	$645.65	$741.31
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $107.15 / $107.15 / $141.25	Professional	QX	$107.15	$107.15	$141.25
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $107.15 / $134.90 / $575.44	Professional	QZ	$107.15	$134.90	$575.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $257.04 / $371.54	Facility		$234.42	$257.04	$371.54