Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $239.88 / $363.08	Facility		$39.81	$239.88	$363.08
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $275.42 / $870.96 / $1,412.54	Professional	AA	$275.42	$870.96	$1,412.54
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $269.15 / $457.09 / $724.44	Professional	QK	$269.15	$457.09	$724.44
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $263.03 / $457.09 / $707.95	Professional	QX	$263.03	$457.09	$707.95
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $275.42 / $371.54 / $602.56	Professional	QY	$275.42	$371.54	$602.56
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $134.90 / $354.81 / $933.25	Professional	QZ	$134.90	$354.81	$933.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.49 / $138.04 / $309.03	Professional	AA	$117.49	$138.04	$309.03
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $58.88 / $81.28 / $141.25	Professional	QK	$58.88	$81.28	$141.25
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $70.79 / $91.20 / $141.25	Professional	QX	$70.79	$91.20	$141.25
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $363.08 / $363.08 / $363.08	Professional	QY	$363.08	$363.08	$363.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $125.89 / $158.49 / $389.05	Professional	QZ	$125.89	$158.49	$389.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $41.69 / $85.11	Facility		$39.81	$41.69	$85.11