Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $602.56 / $645.65 / $831.76	Facility	QX	$602.56	$645.65	$831.76
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $831.76 / $1,584.89 / $2,691.53	Professional	AA	$831.76	$1,584.89	$2,691.53
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $363.08 / $630.96 / $1,023.29	Professional	QX	$363.08	$630.96	$1,023.29
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $380.19 / $588.84 / $977.24	Professional	QY	$380.19	$588.84	$977.24
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $457.09 / $851.14 / $1,288.25	Professional	QZ	$457.09	$851.14	$1,288.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $407.38 / $588.84 / $1,380.38	Professional	AA	$407.38	$588.84	$1,380.38
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $102.33 / $181.97 / $831.76	Professional	QX	$102.33	$181.97	$831.76
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $186.21 / $186.21 / $426.58	Professional	QY	$186.21	$186.21	$426.58
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $199.53 / $389.05 / $524.81	Professional	QZ	$199.53	$389.05	$524.81
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48