Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $158.49 / $645.65 / $1,548.82	Professional	AA	$158.49	$645.65	$1,548.82
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $95.50 / $363.08 / $537.03	Professional	QK	$95.50	$363.08	$537.03
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $194.98 / $380.19 / $575.44	Professional	QX	$194.98	$380.19	$575.44
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $208.93 / $338.84 / $426.58	Professional	QY	$208.93	$338.84	$426.58
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $128.82 / $588.84 / $1,000.00	Professional	QZ	$128.82	$588.84	$1,000.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	AA	$138.04	$138.04	$138.04
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $69.18 / $69.18 / $89.13	Professional	QK	$69.18	$69.18	$89.13
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $69.18 / $69.18 / $89.13	Professional	QX	$69.18	$69.18	$89.13
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $158.49 / $158.49 / $239.88	Professional	QZ	$158.49	$158.49	$239.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56,234.13 / $69,183.10 / $81,283.05	Facility		$56,234.13	$69,183.10	$81,283.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $177.83 / $4,073.80	Facility		$30.20	$177.83	$4,073.80