Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.50 / $275.00 / $764.28	Facility		$43.50	$275.00	$764.28
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $533.50 / $622.47 / $1,186.56	Facility	QZ	$533.50	$622.47	$1,186.56
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $365.90 / $508.74 / $737.30	Professional	AA	$365.90	$508.74	$737.30
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $142.50 / $177.50 / $206.25	Professional	QX	$142.50	$177.50	$206.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $412.72 / $490.00 / $596.15	Professional	QZ	$412.72	$490.00	$596.15
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $114.72 / $576.00 / $630.00	Professional	AA	$114.72	$576.00	$630.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $57.36 / $65.37 / $288.00	Professional	QX	$57.36	$65.37	$288.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $95.60 / $165.39 / $471.66	Professional	QZ	$95.60	$165.39	$471.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.24 / $58.19 / $112.56	Facility		$44.24	$58.19	$112.56
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $274.27 / $274.27 / $342.85	Professional	AA	$274.27	$274.27	$342.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.64 / $80.48 / $610.54	Facility		$21.64	$80.48	$610.54