Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $480.00 / $540.00	Facility		$45.00	$480.00	$540.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $344.80 / $549.00 / $733.13	Professional	AA	$344.80	$549.00	$733.13
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $251.58 / $337.24 / $493.64	Professional	QK	$251.58	$337.24	$493.64
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $274.50 / $303.02 / $425.21	Professional	QX	$274.50	$303.02	$425.21
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $155.25 / $275.33 / $472.50	Professional	QY	$155.25	$275.33	$472.50
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $261.00 / $403.07 / $563.02	Professional	QZ	$261.00	$403.07	$563.02
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $135.59 / $255.84 / $560.00	Professional	AA	$135.59	$255.84	$560.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $69.27 / $98.95 / $262.50	Professional	QK	$69.27	$98.95	$262.50
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $79.16 / $129.66 / $193.94	Professional	QX	$79.16	$129.66	$193.94
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $70.20 / $110.82 / $162.08	Professional	QY	$70.20	$110.82	$162.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $135.59 / $221.65 / $750.00	Professional	QZ	$135.59	$221.65	$750.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $235.00 / $453.55	Facility		$235.00	$235.00	$453.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.22 / $155.93 / $226.63	Facility		$64.22	$155.93	$226.63
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QK	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
United Facility/Professional Professional Modifier AA Low / Median / High Price $75.00 / $75.00 / $75.00	Professional	AA	$75.00	$75.00	$75.00
United Facility/Professional Professional Modifier QX Low / Median / High Price $85.00 / $85.00 / $95.00	Professional	QX	$85.00	$85.00	$95.00