Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	QZ	$489.78	$489.78	$489.78
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $977.24 / $1,479.11	Professional	AA	$446.68	$977.24	$1,479.11
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $257.04 / $407.38 / $630.96	Professional	QK	$257.04	$407.38	$630.96
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $234.42 / $416.87 / $630.96	Professional	QX	$234.42	$416.87	$630.96
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $354.81 / $501.19	Professional	QY	$269.15	$354.81	$501.19
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $125.89 / $398.11 / $891.25	Professional	QZ	$125.89	$398.11	$891.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $128.82 / $186.21 / $257.04	Professional	AA	$128.82	$186.21	$257.04
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $60.26 / $81.28 / $257.04	Professional	QK	$60.26	$81.28	$257.04
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $60.26 / $81.28 / $144.54	Professional	QX	$60.26	$81.28	$144.54
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $61.66 / $100.00 / $138.04	Professional	QY	$61.66	$100.00	$138.04
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $158.49 / $218.78	Professional	QZ	$141.25	$158.49	$218.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $38.90 / $52.48	Facility		$33.11	$38.90	$52.48