Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.25 / $275.00 / $413.75	Facility		$21.25	$275.00	$413.75
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $497.00 / $497.00 / $497.00	Facility	AA	$497.00	$497.00	$497.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $147.61 / $688.50 / $1,260.00	Professional	AA	$147.61	$688.50	$1,260.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $999.90 / $1,193.80 / $1,313.18	Professional	QZ	$999.90	$1,193.80	$1,313.18
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $120.66 / $420.00 / $747.46	Professional	AA	$120.66	$420.00	$747.46
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $133.93 / $133.93 / $133.93	Professional	QK	$133.93	$133.93	$133.93
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $70.39 / $70.39 / $133.93	Professional	QX	$70.39	$70.39	$133.93
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $100.55 / $120.66 / $747.46	Professional	QZ	$100.55	$120.66	$747.46
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $242.60 / $325.00 / $513.20	Professional		$242.60	$325.00	$513.20