Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,254.18 / $1,254.18 / $1,254.18	Facility	QZ	$1,254.18	$1,254.18	$1,254.18
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $496.80 / $632.61 / $1,120.00	Professional	AA	$496.80	$632.61	$1,120.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $214.59 / $341.25 / $597.38	Professional	QK	$214.59	$341.25	$597.38
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $211.52 / $322.92 / $569.60	Professional	QX	$211.52	$322.92	$569.60
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $193.13 / $254.44 / $531.00	Professional	QY	$193.13	$254.44	$531.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $411.80 / $538.65 / $1,062.00	Professional	QZ	$411.80	$538.65	$1,062.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $178.11 / $235.98 / $552.00	Professional	AA	$178.11	$235.98	$552.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $104.88 / $144.21 / $199.70	Professional	QK	$104.88	$144.21	$199.70
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $12.88 / $139.79 / $448.00	Professional	QX	$12.88	$139.79	$448.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $72.56 / $130.30 / $152.38	Professional	QY	$72.56	$130.30	$152.38
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $135.59 / $183.54 / $319.52	Professional	QZ	$135.59	$183.54	$319.52
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