Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $186.30	Facility		$35.00	$35.00	$186.30
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $332.10 / $437.40 / $639.90	Facility	QX	$332.10	$437.40	$639.90
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $348.30 / $348.30 / $348.30	Facility	QZ	$348.30	$348.30	$348.30
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $147.61 / $594.89 / $1,400.00	Professional	AA	$147.61	$594.89	$1,400.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $477.00 / $693.75 / $971.25	Professional	QK	$477.00	$693.75	$971.25
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $416.25 / $675.00 / $971.25	Professional	QX	$416.25	$675.00	$971.25
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $485.62 / $600.00 / $715.50	Professional	QY	$485.62	$600.00	$715.50
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $329.75 / $399.17 / $1,484.00	Professional	QZ	$329.75	$399.17	$1,484.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $360.00 / $618.00 / $910.00	Professional	AA	$360.00	$618.00	$910.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $210.00 / $240.00 / $455.00	Professional	QK	$210.00	$240.00	$455.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $59.62 / $199.50 / $752.00	Professional	QX	$59.62	$199.50	$752.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $585.00 / $585.00 / $585.00	Professional	QY	$585.00	$585.00	$585.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $112.22 / $385.00 / $510.00	Professional	QZ	$112.22	$385.00	$510.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $82.00 / $3,745.00	Facility		$35.00	$82.00	$3,745.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50