Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	QZ	$588.84	$588.84	$588.84
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $501.19 / $1,000.00 / $1,548.82	Professional	AA	$501.19	$1,000.00	$1,548.82
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $281.84 / $446.68 / $741.31	Professional	QK	$281.84	$446.68	$741.31
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $457.09 / $741.31	Professional	QX	$295.12	$457.09	$741.31
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $323.59 / $436.52 / $758.58	Professional	QY	$323.59	$436.52	$758.58
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $323.59 / $478.63 / $1,445.44	Professional	QZ	$323.59	$478.63	$1,445.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $158.49 / $616.60 / $1,000.00	Professional	AA	$158.49	$616.60	$1,000.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $144.54 / $436.52 / $602.56	Professional	QK	$144.54	$436.52	$602.56
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $467.74 / $758.58	Professional	QX	$295.12	$467.74	$758.58
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $354.81 / $354.81 / $602.56	Professional	QY	$354.81	$354.81	$602.56
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $194.98 / $309.03 / $707.95	Professional	QZ	$194.98	$309.03	$707.95
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	QK	$134.90	$134.90	$134.90
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	QX	$134.90	$134.90	$134.90
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	QY	$134.90	$134.90	$134.90
Providence Facility/Professional Professional Modifier QK Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QK	$181.97	$181.97	$181.97
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QX	$181.97	$181.97	$181.97
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	QY	$181.97	$181.97	$181.97