Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.39 / $44.00 / $387.18	Facility		$19.39	$44.00	$387.18
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $765.07 / $765.07 / $765.07	Facility	QZ	$765.07	$765.07	$765.07
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $423.40 / $423.40 / $423.40	Professional	AA	$423.40	$423.40	$423.40
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $164.30 / $186.00 / $251.10	Professional	QK	$164.30	$186.00	$251.10
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $88.44 / $170.50 / $220.10	Professional	QX	$88.44	$170.50	$220.10
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $158.10 / $158.10 / $158.10	Professional	QY	$158.10	$158.10	$158.10
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $162.00 / $286.73 / $394.40	Professional	QZ	$162.00	$286.73	$394.40
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $101.80 / $240.00 / $520.00	Professional	AA	$101.80	$240.00	$520.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $48.48 / $66.56 / $198.00	Professional	QK	$48.48	$66.56	$198.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $48.48 / $61.08 / $78.04	Professional	QX	$48.48	$61.08	$78.04
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $58.17 / $100.00 / $162.50	Professional	QY	$58.17	$100.00	$162.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $96.95 / $118.86 / $228.00	Professional	QZ	$96.95	$118.86	$228.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $82.00 / $3,120.00	Facility		$42.84	$82.00	$3,120.00