Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $980.00 / $1,680.00 / $2,800.00	Professional	AA	$980.00	$1,680.00	$2,800.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $832.50 / $1,125.00 / $1,828.50	Professional	QX	$832.50	$1,125.00	$1,828.50
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $1,272.00 / $1,272.00 / $1,272.00	Professional	QY	$1,272.00	$1,272.00	$1,272.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $1,431.00 / $1,431.00 / $4,770.00	Professional	QZ	$1,431.00	$1,431.00	$4,770.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $220.66 / $935.00 / $1,300.00	Professional	AA	$220.66	$935.00	$1,300.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $110.72 / $247.50 / $484.50	Professional	QX	$110.72	$247.50	$484.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $203.00 / $490.00 / $560.00	Professional	QZ	$203.00	$490.00	$560.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00