Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $235.00 / $400.00	Facility		$45.00	$235.00	$400.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $147.61 / $980.00 / $1,540.00	Professional	AA	$147.61	$980.00	$1,540.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $170.10 / $207.90 / $365.40	Professional	QK	$170.10	$207.90	$365.40
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $173.25 / $311.85 / $1,573.48	Professional	QX	$173.25	$311.85	$1,573.48
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $244.40 / $321.30 / $453.60	Professional	QZ	$244.40	$321.30	$453.60
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $117.06 / $118.20 / $455.00	Professional	AA	$117.06	$118.20	$455.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $58.53 / $81.70 / $132.66	Professional	QK	$58.53	$81.70	$132.66
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $58.53 / $93.38 / $186.00	Professional	QX	$58.53	$93.38	$186.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $105.05 / $105.05 / $105.05	Professional	QY	$105.05	$105.05	$105.05
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $97.55 / $119.34 / $306.00	Professional	QZ	$97.55	$119.34	$306.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.03 / $0.03	Facility		$0.02	$0.03	$0.03
Christus Facility/Professional Facility Modifier Low / Median / High Price $76.54 / $76.54 / $76.54	Facility		$76.54	$76.54	$76.54