Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $703.23 / $1,589.50 / $2,380.00	Professional	AA	$703.23	$1,589.50	$2,380.00
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 QZ Low / Median / High Price $403.07 / $801.00 / $990.00	Professional	QZ	$403.07	$801.00	$990.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $189.83 / $352.53 / $2,758.00	Professional	AA	$189.83	$352.53	$2,758.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $12.88 / $120.36 / $690.00	Professional	QX	$12.88	$120.36	$690.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $128.81 / $128.81 / $128.81	Professional	QY	$128.81	$128.81	$128.81
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.53 / $280.00 / $1,104.00	Professional	QZ	$138.53	$280.00	$1,104.00
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