Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $371.54	Facility		$41.69	$41.69	$371.54
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $457.09 / $588.84 / $870.96	Professional	AA	$457.09	$588.84	$870.96
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $194.98 / $389.05 / $645.65	Professional	QK	$194.98	$389.05	$645.65
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $194.98 / $407.38 / $630.96	Professional	QX	$194.98	$407.38	$630.96
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $245.47 / $346.74 / $457.09	Professional	QY	$245.47	$346.74	$457.09
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $354.81 / $501.19	Professional	QZ	$120.23	$354.81	$501.19
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $162.18 / $616.60	Professional	AA	$138.04	$162.18	$616.60
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $69.18 / $81.28 / $204.17	Professional	QK	$69.18	$81.28	$204.17
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $70.79 / $87.10 / $123.03	Professional	QX	$70.79	$87.10	$123.03
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $70.79 / $100.00 / $204.17	Professional	QY	$70.79	$100.00	$204.17
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $125.89 / $218.78 / $457.09	Professional	QZ	$125.89	$218.78	$457.09
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $467.74 / $724.44	Professional	AA	$354.81	$467.74	$724.44
Qualchoice Facility/Professional Professional Modifier QK Low / Median / High Price $204.17 / $204.17 / $295.12	Professional	QK	$204.17	$204.17	$295.12
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $234.42 / $234.42 / $234.42	Professional	QX	$234.42	$234.42	$234.42
Qualchoice Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $234.42 / $234.42	Professional	QY	$234.42	$234.42	$234.42
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $467.74 / $549.54	Professional	QZ	$354.81	$467.74	$549.54