Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $794.33 / $1,659.59 / $2,951.21	Professional	AA	$794.33	$1,659.59	$2,951.21
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $363.08 / $676.08 / $1,230.27	Professional	QX	$363.08	$676.08	$1,230.27
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $398.11 / $741.31 / $1,949.84	Professional	QY	$398.11	$741.31	$1,949.84
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $851.14 / $2,344.23	Professional	QZ	$446.68	$851.14	$2,344.23
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $154.88 / $275.42 / $891.25	Professional	AA	$154.88	$275.42	$891.25
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $85.11 / $128.82 / $213.80	Professional	QX	$85.11	$128.82	$213.80
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $151.36 / $151.36 / $363.08	Professional	QY	$151.36	$151.36	$363.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $162.18 / $288.40 / $398.11	Professional	QZ	$162.18	$288.40	$398.11
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $190.55 / $213.80 / $213.80	Professional	QX	$190.55	$213.80	$213.80
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $363.08 / $407.38 / $407.38	Professional	QZ	$363.08	$407.38	$407.38
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $758.58 / $1,380.38 / $2,818.38	Professional	AA	$758.58	$1,380.38	$2,818.38
Health Alliance Plan Facility/Professional Professional Modifier QX Low / Median / High Price $331.13 / $630.96 / $1,288.25	Professional	QX	$331.13	$630.96	$1,288.25
Health Alliance Plan Facility/Professional Professional Modifier QY Low / Median / High Price $331.13 / $724.44 / $2,137.96	Professional	QY	$331.13	$724.44	$2,137.96
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $446.68 / $1,548.82 / $2,344.23	Professional	QZ	$446.68	$1,548.82	$2,344.23