Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $350.00 / $350.00	Facility		$40.00	$350.00	$350.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $467.50 / $840.00 / $1,207.90	Professional	AA	$467.50	$840.00	$1,207.90
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $87.03 / $429.31 / $596.66	Professional	QK	$87.03	$429.31	$596.66
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $90.00 / $450.62 / $916.84	Professional	QX	$90.00	$450.62	$916.84
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $253.65 / $370.15 / $531.17	Professional	QY	$253.65	$370.15	$531.17
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $146.94 / $297.60 / $609.00	Professional	QZ	$146.94	$297.60	$609.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $135.52 / $306.00 / $490.00	Professional	AA	$135.52	$306.00	$490.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $113.16 / $158.72 / $455.00	Professional	QK	$113.16	$158.72	$455.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $67.76 / $99.01 / $181.39	Professional	QX	$67.76	$99.01	$181.39
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $99.01 / $99.01 / $210.00	Professional	QY	$99.01	$99.01	$210.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $118.74 / $182.82 / $408.00	Professional	QZ	$118.74	$182.82	$408.00
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QK	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $300.00	Professional	QY	$150.00	$150.00	$300.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50