Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $561.74	Facility		$48.00	$48.00	$561.74
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $345.49 / $432.00 / $980.00	Professional	AA	$345.49	$432.00	$980.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $176.00 / $195.14 / $210.80	Professional	QK	$176.00	$195.14	$210.80
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $138.32 / $138.32 / $220.10	Professional	QX	$138.32	$138.32	$220.10
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $351.62 / $351.62 / $351.62	Professional	QY	$351.62	$351.62	$351.62
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $262.25 / $495.00 / $867.00	Professional	QZ	$262.25	$495.00	$867.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $79.16 / $162.71 / $240.00	Professional	AA	$79.16	$162.71	$240.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $58.53 / $276.00 / $368.00	Professional	QK	$58.53	$276.00	$368.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $48.78 / $60.18 / $276.00	Professional	QX	$48.78	$60.18	$276.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $90.17 / $276.00 / $276.00	Professional	QY	$90.17	$276.00	$276.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $98.95 / $150.44 / $552.00	Professional	QZ	$98.95	$150.44	$552.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.25 / $121.06 / $315.39	Facility		$43.25	$121.06	$315.39
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