Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $433.50 / $505.75 / $1,071.00	Professional	AA	$433.50	$505.75	$1,071.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $252.80 / $329.60 / $508.80	Professional	QX	$252.80	$329.60	$508.80
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $252.88 / $325.13 / $361.25	Professional	QY	$252.88	$325.13	$361.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $722.50 / $1,156.00 / $1,445.00	Professional	QZ	$722.50	$1,156.00	$1,445.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $459.00 / $867.00 / $1,760.00	Professional	AA	$459.00	$867.00	$1,760.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $139.78 / $139.78 / $382.50	Professional	QX	$139.78	$139.78	$382.50
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $592.37 / $592.37 / $592.37	Professional	QY	$592.37	$592.37	$592.37
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $510.00 / $612.00 / $1,100.00	Professional	QZ	$510.00	$612.00	$1,100.00
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $645.15 / $997.05 / $2,024.00	Professional	AA	$645.15	$997.05	$2,024.00
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $661.25 / $703.80 / $1,265.00	Professional	QZ	$661.25	$703.80	$1,265.00
United Facility/Professional Professional Modifier QY Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	QY	$80.00	$80.00	$80.00