Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $562.65 / $562.65 / $562.65	Facility	QX	$562.65	$562.65	$562.65
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $756.00 / $1,140.00 / $1,470.60	Professional	AA	$756.00	$1,140.00	$1,470.60
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $501.65 / $590.54 / $846.00	Professional	QK	$501.65	$590.54	$846.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $490.05 / $592.25 / $775.50	Professional	QX	$490.05	$592.25	$775.50
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $442.75 / $520.70 / $736.56	Professional	QY	$442.75	$520.70	$736.56
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $165.63 / $1,269.00 / $2,208.44	Professional	QZ	$165.63	$1,269.00	$2,208.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $186.57 / $600.00 / $1,300.00	Professional	AA	$186.57	$600.00	$1,300.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $139.10 / $350.00 / $517.50	Professional	QK	$139.10	$350.00	$517.50
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $82.92 / $437.50 / $940.00	Professional	QX	$82.92	$437.50	$940.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $72.56 / $393.75 / $585.00	Professional	QY	$72.56	$393.75	$585.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $145.11 / $784.00 / $1,170.00	Professional	QZ	$145.11	$784.00	$1,170.00
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QK	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00