Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $288.00 / $592.23	Facility		$45.00	$288.00	$592.23
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $136.61 / $1,120.00 / $1,960.00	Professional	AA	$136.61	$1,120.00	$1,960.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $185.85 / $226.80 / $365.40	Professional	QK	$185.85	$226.80	$365.40
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $138.32 / $214.20 / $390.60	Professional	QX	$138.32	$214.20	$390.60
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $179.55 / $192.15 / $245.70	Professional	QY	$179.55	$192.15	$245.70
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $116.85 / $348.40 / $416.00	Professional	QZ	$116.85	$348.40	$416.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $118.20 / $140.41 / $210.11	Professional	AA	$118.20	$140.41	$210.11
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $78.04 / $81.70 / $97.55	Professional	QK	$78.04	$81.70	$97.55
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $81.70 / $87.80 / $204.00	Professional	QX	$81.70	$87.80	$204.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $93.38 / $93.38 / $162.36	Professional	QY	$93.38	$93.38	$162.36
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $119.34 / $159.12 / $306.00	Professional	QZ	$119.34	$159.12	$306.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.03 / $0.03	Facility		$0.02	$0.03	$0.03
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.11 / $80.11 / $120.30	Facility		$80.11	$80.11	$120.30
United Facility/Professional Professional Modifier AA Low / Median / High Price $365.00 / $365.00 / $1,445.60	Professional	AA	$365.00	$365.00	$1,445.60