Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $371.54 / $537.03	Facility		$41.69	$371.54	$537.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $346.74 / $616.60 / $1,230.27	Professional	AA	$346.74	$616.60	$1,230.27
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $95.50 / $338.84 / $575.44	Professional	QK	$95.50	$338.84	$575.44
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $177.83 / $346.74 / $588.84	Professional	QX	$177.83	$346.74	$588.84
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $208.93 / $331.13 / $512.86	Professional	QY	$208.93	$331.13	$512.86
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $309.03 / $549.54 / $741.31	Professional	QZ	$309.03	$549.54	$741.31
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $128.82 / $194.98 / $407.38	Professional	AA	$128.82	$194.98	$407.38
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $66.07 / $120.23 / $257.04	Professional	QK	$66.07	$120.23	$257.04
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $63.10 / $93.33 / $229.09	Professional	QX	$63.10	$93.33	$229.09
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $58.88 / $107.15 / $234.42	Professional	QY	$58.88	$107.15	$234.42
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $169.82 / $407.38	Professional	QZ	$120.23	$169.82	$407.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $83.18 / $3,019.95	Facility		$42.66	$83.18	$3,019.95
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QK	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QX	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QY	$39.81	$39.81	$39.81
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $354.81 / $354.81 / $467.74	Professional	AA	$354.81	$354.81	$467.74
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $407.38 / $467.74	Professional	QZ	$354.81	$407.38	$467.74