Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $400.00 / $450.00	Facility		$45.00	$400.00	$450.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $345.49 / $452.40 / $594.00	Professional	AA	$345.49	$452.40	$594.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $195.14 / $261.00 / $268.63	Professional	QK	$195.14	$261.00	$268.63
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $138.32 / $176.00 / $196.00	Professional	QX	$138.32	$176.00	$196.00
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $237.12 / $237.12 / $351.62	Professional	QY	$237.12	$237.12	$351.62
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $262.25 / $364.40 / $495.00	Professional	QZ	$262.25	$364.40	$495.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $121.06 / $162.71 / $400.00	Professional	AA	$121.06	$162.71	$400.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $50.15 / $59.37 / $85.23	Professional	QK	$50.15	$59.37	$85.23
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $49.48 / $81.04 / $113.45	Professional	QX	$49.48	$81.04	$113.45
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $53.18 / $90.17 / $97.25	Professional	QY	$53.18	$90.17	$97.25
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $96.85 / $154.57 / $375.00	Professional	QZ	$96.85	$154.57	$375.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $386.00	Facility		$200.00	$200.00	$386.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.04 / $104.60 / $174.33	Facility		$39.04	$104.60	$174.33
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