Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $302.00 / $537.03	Facility		$44.67	$302.00	$537.03
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $87.10 / $100.00 / $223.87	Facility	QX	$87.10	$100.00	$223.87
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,230.27 / $1,230.27 / $1,659.59	Facility	QZ	$1,230.27	$1,230.27	$1,659.59
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $794.33 / $1,318.26	Professional	AA	$436.52	$794.33	$1,318.26
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $141.25 / $371.54 / $676.08	Professional	QK	$141.25	$371.54	$676.08
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $181.97 / $363.08 / $660.69	Professional	QX	$181.97	$363.08	$660.69
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $213.80 / $346.74 / $630.96	Professional	QY	$213.80	$346.74	$630.96
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $562.34 / $812.83	Professional	QZ	$354.81	$562.34	$812.83
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $204.17 / $588.84	Professional	AA	$138.04	$204.17	$588.84
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $66.07 / $104.71 / $257.04	Professional	QK	$66.07	$104.71	$257.04
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $66.07 / $100.00 / $263.03	Professional	QX	$66.07	$100.00	$263.03
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $63.10 / $117.49 / $147.91	Professional	QY	$63.10	$117.49	$147.91
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $162.18 / $389.05	Professional	QZ	$120.23	$162.18	$389.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $323.59 / $501.19	Professional		$169.82	$323.59	$501.19
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00