Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $633.36 / $633.36 / $633.36	Facility	QX	$633.36	$633.36	$633.36
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $825.30 / $1,680.00 / $2,660.00	Professional	AA	$825.30	$1,680.00	$2,660.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $253.50 / $734.93 / $1,346.15	Professional	QX	$253.50	$734.93	$1,346.15
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $423.80 / $449.23 / $749.48	Professional	QY	$423.80	$449.23	$749.48
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $176.18 / $427.20 / $926.40	Professional	QZ	$176.18	$427.20	$926.40
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $197.80 / $237.36 / $237.36	Professional	AA	$197.80	$237.36	$237.36
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $110.33 / $177.03 / $1,082.24	Professional	QX	$110.33	$177.03	$1,082.24
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $127.58 / $127.58 / $141.62	Professional	QY	$127.58	$127.58	$141.62
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $446.53 / $446.53 / $663.00	Professional	QZ	$446.53	$446.53	$663.00
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $175.00 / $292.50 / $425.90	Professional	AA	$175.00	$292.50	$425.90
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $49.45 / $87.50 / $189.05	Professional	QX	$49.45	$87.50	$189.05
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $140.00 / $200.00 / $302.50	Professional	QZ	$140.00	$200.00	$302.50