Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $626.40 / $997.15	Facility		$40.00	$626.40	$997.15
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $525.90 / $525.90 / $562.65	Facility	QX	$525.90	$525.90	$562.65
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $235.41 / $844.20 / $995.40	Professional	AA	$235.41	$844.20	$995.40
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $349.25 / $442.75 / $520.70	Professional	QK	$349.25	$442.75	$520.70
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $361.95 / $432.25 / $493.50	Professional	QX	$361.95	$432.25	$493.50
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $332.75 / $387.35 / $565.88	Professional	QY	$332.75	$387.35	$565.88
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $598.00 / $987.00 / $1,309.44	Professional	QZ	$598.00	$987.00	$1,309.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $103.65 / $300.00 / $780.00	Professional	AA	$103.65	$300.00	$780.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $51.83 / $245.88 / $575.00	Professional	QK	$51.83	$245.88	$575.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $62.19 / $336.00 / $658.00	Professional	QX	$62.19	$336.00	$658.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $62.19 / $402.50 / $455.00	Professional	QY	$62.19	$402.50	$455.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $102.40 / $544.00 / $784.00	Professional	QZ	$102.40	$544.00	$784.00
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 / $150.00	Professional	QY	$150.00	$150.00	$150.00