Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $200.00 / $300.00	Facility		$40.00	$200.00	$300.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $224.00 / $224.00 / $280.00	Professional	AA	$224.00	$224.00	$280.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $588.00 / $663.60 / $810.00	Professional	QZ	$588.00	$663.60	$810.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $118.20 / $118.20 / $140.35	Professional	AA	$118.20	$118.20	$140.35
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $59.10 / $59.10 / $59.10	Professional	QK	$59.10	$59.10	$59.10
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $59.10 / $59.10 / $59.10	Professional	QX	$59.10	$59.10	$59.10
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $118.20 / $159.57 / $496.00	Professional	QZ	$118.20	$159.57	$496.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $42.00	Facility		$40.00	$40.00	$42.00