Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $645.32 / $645.32 / $645.32	Facility	QK	$645.32	$645.32	$645.32
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,093.08 / $1,093.08 / $1,093.08	Facility	QX	$1,093.08	$1,093.08	$1,093.08
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $663.66 / $663.66 / $663.66	Facility	QY	$663.66	$663.66	$663.66
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $793.10 / $1,198.50 / $1,680.00	Professional	AA	$793.10	$1,198.50	$1,680.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $340.80 / $535.50 / $1,394.40	Professional	QZ	$340.80	$535.50	$1,394.40
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.46 / $217.58 / $276.43	Professional	AA	$138.46	$217.58	$276.43
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $191.37 / $191.37 / $561.00	Professional	QZ	$191.37	$191.37	$561.00
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 QZ Low / Median / High Price $140.00 / $200.00 / $302.50	Professional	QZ	$140.00	$200.00	$302.50