Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $1,174.90 / $2,398.83	Facility		$363.08	$1,174.90	$2,398.83
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $446.68 / $812.83 / $1,258.93	Professional	AA	$446.68	$812.83	$1,258.93
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $117.49 / $380.19 / $588.84	Professional	QK	$117.49	$380.19	$588.84
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $213.80 / $389.05 / $602.56	Professional	QX	$213.80	$389.05	$602.56
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $257.04 / $354.81 / $512.86	Professional	QY	$257.04	$354.81	$512.86
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $251.19 / $575.44 / $891.25	Professional	QZ	$251.19	$575.44	$891.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $154.88 / $218.78	Professional	AA	$138.04	$154.88	$218.78
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $66.07 / $69.18 / $89.13	Professional	QK	$66.07	$69.18	$89.13
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $66.07 / $87.10 / $169.82	Professional	QX	$66.07	$87.10	$169.82
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $109.65 / $109.65 / $112.20	Professional	QY	$109.65	$109.65	$112.20
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $162.18 / $218.78	Professional	QZ	$120.23	$162.18	$218.78
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Facility		$426.58	$426.58	$426.58
AmeriHealth Facility/Professional Professional Modifier QK Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	QK	$17.78	$17.78	$17.78
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68