Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $569.52 / $610.00	Facility		$30.00	$569.52	$610.00
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $233.75 / $243.46 / $243.46	Facility	QX	$233.75	$243.46	$243.46
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $609.50 / $766.53 / $934.21	Professional	AA	$609.50	$766.53	$934.21
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $61.84 / $395.30 / $628.79	Professional	QK	$61.84	$395.30	$628.79
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $58.23 / $371.29 / $658.74	Professional	QX	$58.23	$371.29	$658.74
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $305.41 / $353.32 / $658.74	Professional	QY	$305.41	$353.32	$658.74
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $100.00 / $153.11 / $200.90	Professional	QZ	$100.00	$153.11	$200.90
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $518.00 / $592.00 / $666.00	Professional	AA	$518.00	$592.00	$666.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $78.52 / $194.00 / $701.25	Professional	QK	$78.52	$194.00	$701.25
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $129.56 / $194.00 / $273.00	Professional	QX	$129.56	$194.00	$273.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $162.36 / $162.36 / $252.50	Professional	QY	$162.36	$162.36	$252.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.78 / $339.50 / $994.00	Professional	QZ	$117.78	$339.50	$994.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,950.00 / $3,990.00	Facility		$1,200.00	$1,950.00	$3,990.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,913.09 / $2,913.09 / $6,311.00	Facility		$2,913.09	$2,913.09	$6,311.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50