Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $577.15 / $738.70 / $1,132.56	Professional	AA	$577.15	$738.70	$1,132.56
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $214.59 / $415.80 / $566.28	Professional	QK	$214.59	$415.80	$566.28
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $204.75 / $356.40 / $557.70	Professional	QX	$204.75	$356.40	$557.70
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $223.78 / $299.00 / $508.20	Professional	QY	$223.78	$299.00	$508.20
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $472.09 / $538.65 / $836.00	Professional	QZ	$472.09	$538.65	$836.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $160.47 / $182.25 / $191.43	Professional	AA	$160.47	$182.25	$191.43
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $85.08 / $114.86 / $143.57	Professional	QK	$85.08	$114.86	$143.57
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $74.45 / $106.35 / $132.94	Professional	QX	$74.45	$106.35	$132.94
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $74.45 / $91.13 / $297.00	Professional	QY	$74.45	$91.13	$297.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.75 / $162.00 / $283.50	Professional	QZ	$141.75	$162.00	$283.50
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $97.90 / $214.97 / $254.25	Professional	QX	$97.90	$214.97	$254.25
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $184.90 / $406.06 / $480.25	Professional	QZ	$184.90	$406.06	$480.25
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $180.00 / $180.00 / $566.60	Professional	QK	$180.00	$180.00	$566.60
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $566.60	Professional	QX	$180.00	$180.00	$566.60
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $566.60	Professional	QY	$180.00	$180.00	$566.60
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $605.90 / $871.50 / $1,898.82	Professional	AA	$605.90	$871.50	$1,898.82
Health Alliance Plan Facility/Professional Professional Modifier QK Low / Median / High Price $276.00 / $452.10 / $600.60	Professional	QK	$276.00	$452.10	$600.60
Health Alliance Plan Facility/Professional Professional Modifier QX Low / Median / High Price $187.00 / $387.60 / $579.15	Professional	QX	$187.00	$387.60	$579.15
Health Alliance Plan Facility/Professional Professional Modifier QY Low / Median / High Price $226.85 / $369.60 / $508.20	Professional	QY	$226.85	$369.60	$508.20
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $425.88 / $504.00 / $836.00	Professional	QZ	$425.88	$504.00	$836.00