Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $479.85 / $713.58 / $909.00	Professional	AA	$479.85	$713.58	$909.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $282.88 / $342.35 / $953.06	Professional	QK	$282.88	$342.35	$953.06
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $162.00 / $335.80 / $409.50	Professional	QX	$162.00	$335.80	$409.50
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $74.37 / $409.50 / $493.64	Professional	QY	$74.37	$409.50	$493.64
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $310.50 / $467.05 / $577.50	Professional	QZ	$310.50	$467.05	$577.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $160.88 / $249.35 / $640.00	Professional	AA	$160.88	$249.35	$640.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $80.23 / $167.45 / $210.70	Professional	QK	$80.23	$167.45	$210.70
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $12.88 / $129.66 / $337.50	Professional	QX	$12.88	$129.66	$337.50
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $74.45 / $157.50 / $337.50	Professional	QY	$74.45	$157.50	$337.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.53 / $216.94 / $750.00	Professional	QZ	$138.53	$216.94	$750.00
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