Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $504.63 / $504.63 / $504.63	Facility	QZ	$504.63	$504.63	$504.63
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $479.48 / $550.23 / $1,120.00	Professional	AA	$479.48	$550.23	$1,120.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $78.25 / $238.70 / $263.50	Professional	QK	$78.25	$238.70	$263.50
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $147.94 / $240.00 / $275.89	Professional	QX	$147.94	$240.00	$275.89
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $649.64 / $649.64 / $649.64	Professional	QY	$649.64	$649.64	$649.64
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $460.66 / $654.50 / $1,343.25	Professional	QZ	$460.66	$654.50	$1,343.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $158.32 / $217.69 / $454.44	Professional	AA	$158.32	$217.69	$454.44
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $77.44 / $322.00 / $460.00	Professional	QK	$77.44	$322.00	$460.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $79.16 / $111.32 / $414.00	Professional	QX	$79.16	$111.32	$414.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $96.80 / $322.00 / $414.00	Professional	QY	$96.80	$322.00	$414.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.53 / $175.53 / $736.00	Professional	QZ	$138.53	$175.53	$736.00
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