Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.81 / $1,436.40 / $2,884.75	Facility		$33.81	$1,436.40	$2,884.75
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $99.55 / $884.00 / $1,239.59	Professional	AA	$99.55	$884.00	$1,239.59
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $112.50 / $239.29 / $378.73	Professional	QK	$112.50	$239.29	$378.73
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $138.32 / $268.42 / $312.55	Professional	QX	$138.32	$268.42	$312.55
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $67.50 / $210.80 / $520.15	Professional	QY	$67.50	$210.80	$520.15
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $161.26 / $168.72 / $455.00	Professional	AA	$161.26	$168.72	$455.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $63.27 / $119.95 / $480.00	Professional	QK	$63.27	$119.95	$480.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $80.63 / $119.95 / $153.00	Professional	QX	$80.63	$119.95	$153.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $306.00 / $330.00 / $464.00	Professional	QZ	$306.00	$330.00	$464.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $431.28 / $431.28 / $431.28	Facility		$431.28	$431.28	$431.28
AmeriHealth Facility/Professional Professional Modifier QK Low / Median / High Price $17.85 / $17.85 / $17.85	Professional	QK	$17.85	$17.85	$17.85
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $450.00 / $450.00	Facility		$450.00	$450.00	$450.00
United Facility/Professional Professional Modifier AA Low / Median / High Price $75.00 / $350.00 / $365.00	Professional	AA	$75.00	$350.00	$365.00