Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $416.87 / $724.44	Facility		$30.20	$416.87	$724.44
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $91.20 / $107.15 / $194.98	Facility	QX	$91.20	$107.15	$194.98
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $478.63 / $812.83 / $1,230.27	Professional	AA	$478.63	$812.83	$1,230.27
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $190.55 / $398.11 / $676.08	Professional	QK	$190.55	$398.11	$676.08
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $102.33 / $389.05 / $707.95	Professional	QX	$102.33	$389.05	$707.95
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $239.88 / $363.08 / $575.44	Professional	QY	$239.88	$363.08	$575.44
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $234.42 / $537.03 / $707.95	Professional	QZ	$234.42	$537.03	$707.95
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $229.09 / $707.95	Professional	AA	$138.04	$229.09	$707.95
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $67.61 / $85.11 / $281.84	Professional	QK	$67.61	$85.11	$281.84
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $67.61 / $112.20 / $426.58	Professional	QX	$67.61	$112.20	$426.58
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $61.66 / $109.65 / $407.38	Professional	QY	$61.66	$109.65	$407.38
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $173.78 / $524.81	Professional	QZ	$120.23	$173.78	$524.81
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $2,238.72 / $3,981.07	Facility		$33.11	$2,238.72	$3,981.07
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $3,715.35	Facility		$2,187.76	$2,187.76	$3,715.35
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48