Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $607.20 / $955.70	Facility		$40.00	$607.20	$955.70
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $562.65 / $562.65 / $562.65	Facility	QX	$562.65	$562.65	$562.65
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,288.81 / $1,288.81 / $1,288.81	Facility	QZ	$1,288.81	$1,288.81	$1,288.81
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $720.00 / $917.70 / $1,125.30	Professional	AA	$720.00	$917.70	$1,125.30
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $356.95 / $476.25 / $679.52	Professional	QK	$356.95	$476.25	$679.52
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $356.95 / $477.95 / $679.52	Professional	QX	$356.95	$477.95	$679.52
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $429.55 / $442.75 / $654.72	Professional	QY	$429.55	$442.75	$654.72
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $147.18 / $987.00 / $1,551.00	Professional	QZ	$147.18	$987.00	$1,551.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $145.11 / $408.00 / $896.00	Professional	AA	$145.11	$408.00	$896.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $75.87 / $262.50 / $517.50	Professional	QK	$75.87	$262.50	$517.50
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $72.56 / $381.50 / $752.00	Professional	QX	$72.56	$381.50	$752.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $82.92 / $393.75 / $585.00	Professional	QY	$82.92	$393.75	$585.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $124.38 / $612.50 / $910.00	Professional	QZ	$124.38	$612.50	$910.00
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QK	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QY	$150.00	$150.00	$150.00