Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.72 / $306.55 / $445.05	Facility		$28.72	$306.55	$445.05
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,254.18 / $1,254.18 / $1,254.18	Facility	QZ	$1,254.18	$1,254.18	$1,254.18
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $225.50 / $466.65 / $826.20	Professional	AA	$225.50	$466.65	$826.20
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $179.40 / $292.50 / $485.94	Professional	QK	$179.40	$292.50	$485.94
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $171.67 / $251.25 / $452.25	Professional	QX	$171.67	$251.25	$452.25
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $153.28 / $168.60 / $296.70	Professional	QY	$153.28	$168.60	$296.70
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $315.51 / $386.95 / $892.50	Professional	QZ	$315.51	$386.95	$892.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $116.22 / $147.49 / $476.00	Professional	AA	$116.22	$147.49	$476.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $57.36 / $78.66 / $88.49	Professional	QK	$57.36	$78.66	$88.49
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $10.65 / $68.83 / $560.00	Professional	QX	$10.65	$68.83	$560.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $86.87 / $90.17 / $90.17	Professional	QY	$86.87	$90.17	$90.17
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $96.85 / $139.04 / $455.00	Professional	QZ	$96.85	$139.04	$455.00
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
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $113.62 / $220.00 / $359.18	Professional		$113.62	$220.00	$359.18
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00