Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $611.04 / $884.40 / $1,038.18	Professional	AA	$611.04	$884.40	$1,038.18
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $348.48 / $522.72 / $846.45	Professional	QX	$348.48	$522.72	$846.45
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $542.52 / $542.52 / $877.80	Professional	QY	$542.52	$542.52	$877.80
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $502.67 / $502.67 / $989.40	Professional	QZ	$502.67	$502.67	$989.40
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $162.00 / $220.66 / $516.86	Professional	AA	$162.00	$220.66	$516.86
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $132.94 / $212.70 / $305.76	Professional	QX	$132.94	$212.70	$305.76
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $151.88 / $151.88 / $276.51	Professional	QY	$151.88	$151.88	$276.51
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.75 / $141.75 / $141.75	Professional	QZ	$141.75	$141.75	$141.75
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $97.90 / $214.97 / $254.25	Professional	QX	$97.90	$214.97	$254.25
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $184.90 / $406.06 / $480.25	Professional	QZ	$184.90	$406.06	$480.25
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $408.00	Professional	QX	$180.00	$180.00	$408.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $408.00	Professional	QY	$180.00	$180.00	$408.00
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $611.04 / $909.50 / $1,038.18	Professional	AA	$611.04	$909.50	$1,038.18
Health Alliance Plan Facility/Professional Professional Modifier QX Low / Median / High Price $348.48 / $534.60 / $858.00	Professional	QX	$348.48	$534.60	$858.00
Health Alliance Plan Facility/Professional Professional Modifier QY Low / Median / High Price $542.52 / $542.52 / $877.80	Professional	QY	$542.52	$542.52	$877.80
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $824.50 / $824.50 / $989.40	Professional	QZ	$824.50	$824.50	$989.40