Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility	QX	$1,258.93	$1,258.93	$1,258.93
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	QZ	$162.18	$162.18	$162.18
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $478.63 / $707.95 / $1,348.96	Professional	AA	$478.63	$707.95	$1,348.96
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $245.47 / $389.05 / $562.34	Professional	QK	$245.47	$389.05	$562.34
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $239.88 / $398.11 / $588.84	Professional	QX	$239.88	$398.11	$588.84
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $309.03 / $407.38 / $707.95	Professional	QY	$309.03	$407.38	$707.95
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $380.19 / $630.96 / $812.83	Professional	QZ	$380.19	$630.96	$812.83
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $147.91 / $199.53 / $446.68	Professional	AA	$147.91	$199.53	$446.68
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $81.28 / $109.65 / $295.12	Professional	QK	$81.28	$109.65	$295.12
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $77.62 / $107.15 / $295.12	Professional	QX	$77.62	$107.15	$295.12
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $67.61 / $95.50 / $354.81	Professional	QY	$67.61	$95.50	$354.81
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $141.25 / $177.83 / $457.09	Professional	QZ	$141.25	$177.83	$457.09
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QK	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QX	$39.81	$39.81	$39.81
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	QY	$39.81	$39.81	$39.81
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	AA	$407.38	$407.38	$407.38
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	QX	$204.17	$204.17	$204.17
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $467.74 / $524.81 / $588.84	Professional	QZ	$467.74	$524.81	$588.84