Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $583.44 / $583.44 / $583.44	Facility	QZ	$583.44	$583.44	$583.44
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $139.59 / $364.00 / $431.20	Professional	QZ	$139.59	$364.00	$431.20
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $67.59 / $86.90 / $455.00	Professional	QK	$67.59	$86.90	$455.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $70.95 / $115.14 / $191.86	Professional	QX	$70.95	$115.14	$191.86
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $422.50 / $422.50 / $422.50	Professional	QY	$422.50	$422.50	$422.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $136.57 / $184.37 / $273.82	Professional	QZ	$136.57	$184.37	$273.82