Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $262.50 / $300.00	Facility		$40.00	$262.50	$300.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $248.00 / $248.00 / $630.00	Professional	AA	$248.00	$248.00	$630.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $663.60 / $686.00 / $884.80	Professional	QZ	$663.60	$686.00	$884.80
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $98.50 / $118.20 / $137.90	Professional	AA	$98.50	$118.20	$137.90
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $49.25 / $59.10 / $59.10	Professional	QK	$49.25	$59.10	$59.10
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $49.25 / $162.50 / $292.50	Professional	QX	$49.25	$162.50	$292.50
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $59.10 / $59.10 / $59.10	Professional	QY	$59.10	$59.10	$59.10
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $98.50 / $118.20 / $434.00	Professional	QZ	$98.50	$118.20	$434.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $42.00	Facility		$40.00	$40.00	$42.00