Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $350.00 / $350.00	Facility		$40.00	$350.00	$350.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $565.50 / $840.00 / $1,120.58	Professional	AA	$565.50	$840.00	$1,120.58
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $93.00 / $443.87 / $618.50	Professional	QK	$93.00	$443.87	$618.50
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $148.50 / $458.42 / $873.18	Professional	QX	$148.50	$458.42	$873.18
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $91.50 / $364.79 / $516.63	Professional	QY	$91.50	$364.79	$516.63
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $98.64 / $302.39 / $532.00	Professional	QZ	$98.64	$302.39	$532.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $77.44 / $160.72 / $760.00	Professional	AA	$77.44	$160.72	$760.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $48.40 / $67.76 / $99.01	Professional	QK	$48.40	$67.76	$99.01
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $48.78 / $74.20 / $136.04	Professional	QX	$48.78	$74.20	$136.04
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $98.95 / $151.01 / $390.00	Professional	QZ	$98.95	$151.01	$390.00
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 / $300.00	Professional	QY	$150.00	$150.00	$300.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50