Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $316.23 / $478.63 / $1,380.38	Facility	QX	$316.23	$478.63	$1,380.38
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $537.03 / $1,000.00 / $1,698.24	Professional	AA	$537.03	$1,000.00	$1,698.24
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $616.60 / $1,023.29	Professional	QZ	$354.81	$616.60	$1,023.29
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $158.49 / $354.81 / $1,122.02	Professional	AA	$158.49	$354.81	$1,122.02
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $173.78 / $302.00 / $1,258.93	Professional	QZ	$173.78	$302.00	$1,258.93
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