Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $116.62 / $116.62 / $116.62	Facility	QK	$116.62	$116.62	$116.62
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $752.08 / $752.08 / $933.30	Facility	QX	$752.08	$752.08	$933.30
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $624.10 / $997.60 / $2,380.00	Professional	AA	$624.10	$997.60	$2,380.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $456.00 / $660.00 / $929.25	Professional	QX	$456.00	$660.00	$929.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $386.95 / $892.50 / $1,698.47	Professional	QZ	$386.95	$892.50	$1,698.47
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $189.83 / $352.53 / $471.96	Professional	AA	$189.83	$352.53	$471.96
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $12.88 / $138.53 / $252.58	Professional	QX	$12.88	$138.53	$252.58
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $128.81 / $128.81 / $235.50	Professional	QY	$128.81	$128.81	$235.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $118.86 / $271.18 / $387.88	Professional	QZ	$118.86	$271.18	$387.88
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00