Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $457.09 / $537.03	Facility		$331.13	$457.09	$537.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $338.84 / $630.96 / $977.24	Professional	AA	$338.84	$630.96	$977.24
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $162.18 / $380.19 / $630.96	Professional	QK	$162.18	$380.19	$630.96
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $213.80 / $380.19 / $616.60	Professional	QX	$213.80	$380.19	$616.60
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $275.42 / $354.81 / $616.60	Professional	QY	$275.42	$354.81	$616.60
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $263.03 / $489.78 / $794.33	Professional	QZ	$263.03	$489.78	$794.33
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $141.25 / $190.55 / $645.65	Professional	AA	$141.25	$190.55	$645.65
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $69.18 / $112.20 / $263.03	Professional	QK	$69.18	$112.20	$263.03
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $67.61 / $97.72 / $162.18	Professional	QX	$67.61	$97.72	$162.18
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $57.54 / $74.13 / $181.97	Professional	QY	$57.54	$74.13	$181.97
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $173.78 / $457.09	Professional	QZ	$120.23	$173.78	$457.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $457.09	Facility		$234.42	$234.42	$457.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $77.62 / $229.09	Facility		$63.10	$77.62	$229.09