Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $873.54 / $1,239.83 / $2,380.00	Professional	AA	$873.54	$1,239.83	$2,380.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $271.25 / $385.43 / $598.44	Professional	QX	$271.25	$385.43	$598.44
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $301.89 / $328.05 / $586.42	Professional	QY	$301.89	$328.05	$586.42
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $705.40 / $822.57 / $932.25	Professional	QZ	$705.40	$822.57	$932.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $189.83 / $352.53 / $1,105.00	Professional	AA	$189.83	$352.53	$1,105.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $110.33 / $375.00 / $715.00	Professional	QX	$110.33	$375.00	$715.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $129.02 / $196.59 / $235.50	Professional	QY	$129.02	$196.59	$235.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $200.60 / $200.60 / $260.77	Professional	QZ	$200.60	$200.60	$260.77
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $174.00 / $180.00 / $180.00	Professional	QX	$174.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $174.00 / $180.00 / $180.00	Professional	QY	$174.00	$180.00	$180.00
Medical Mutual of Ohio Facility/Professional Professional Modifier QX Low / Median / High Price $2.77 / $51.00 / $58.50	Professional	QX	$2.77	$51.00	$58.50
Medical Mutual of Ohio Facility/Professional Professional Modifier QY Low / Median / High Price $50.63 / $50.63 / $50.63	Professional	QY	$50.63	$50.63	$50.63
United Facility/Professional Professional Modifier QY Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	QY	$80.00	$80.00	$80.00