Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $701.25 / $809.34 / $8,124.74	Facility	QX	$701.25	$809.34	$8,124.74
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $483.80 / $946.18 / $1,281.54	Professional	AA	$483.80	$946.18	$1,281.54
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $214.86 / $214.86 / $214.86	Professional	QZ	$214.86	$214.86	$214.86
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $436.50 / $666.00 / $1,036.00	Professional	AA	$436.50	$666.00	$1,036.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $455.00 / $1,000.00 / $1,704.00	Professional	QZ	$455.00	$1,000.00	$1,704.00
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50