Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $51.40 / $536.45	Facility		$30.00	$51.40	$536.45
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $241.33 / $314.50 / $738.65	Facility	QK	$241.33	$314.50	$738.65
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $980.00 / $980.00 / $980.00	Facility	QX	$980.00	$980.00	$980.00
Aetna Facility/Professional Facility Modifier QY Low / Median / High Price $249.95 / $249.95 / $249.95	Facility	QY	$249.95	$249.95	$249.95
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $268.13 / $772.49 / $1,062.36	Professional	AA	$268.13	$772.49	$1,062.36
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $90.07 / $400.21 / $574.84	Professional	QK	$90.07	$400.21	$574.84
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $97.50 / $429.31 / $902.29	Professional	QX	$97.50	$429.31	$902.29
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $146.83 / $370.15 / $531.17	Professional	QY	$146.83	$370.15	$531.17
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $232.56 / $321.30 / $587.64	Professional	QZ	$232.56	$321.30	$587.64
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $118.68 / $191.37 / $233.90	Professional	AA	$118.68	$191.37	$233.90
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $63.79 / $110.77 / $256.00	Professional	QK	$63.79	$110.77	$256.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $83.08 / $123.92 / $318.00	Professional	QX	$83.08	$123.92	$318.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $74.42 / $85.05 / $744.04	Professional	QY	$74.42	$85.05	$744.04
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $118.68 / $148.84 / $636.00	Professional	QZ	$118.68	$148.84	$636.00
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $140.00 / $234.00 / $340.72	Professional	AA	$140.00	$234.00	$340.72
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $39.56 / $70.00 / $151.24	Professional	QX	$39.56	$70.00	$151.24
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $112.00 / $160.00 / $242.00	Professional	QZ	$112.00	$160.00	$242.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $1,950.00 / $3,000.00	Facility		$30.00	$1,950.00	$3,000.00