Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $361.90 / $361.90 / $607.75	Facility	QX	$361.90	$361.90	$607.75
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $624.10 / $910.25 / $1,245.60	Professional	AA	$624.10	$910.25	$1,245.60
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $385.25 / $503.03 / $661.25	Professional	QK	$385.25	$503.03	$661.25
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $151.16 / $500.25 / $661.25	Professional	QX	$151.16	$500.25	$661.25
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $373.75 / $401.23 / $501.50	Professional	QY	$373.75	$401.23	$501.50
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $143.04 / $826.41 / $826.41	Professional	QZ	$143.04	$826.41	$826.41
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $592.00 / $666.00 / $814.00	Professional	AA	$592.00	$666.00	$814.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $98.15 / $194.00 / $935.00	Professional	QK	$98.15	$194.00	$935.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $95.69 / $194.00 / $409.50	Professional	QX	$95.69	$194.00	$409.50
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $68.70 / $107.97 / $162.36	Professional	QY	$68.70	$107.97	$162.36
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $137.41 / $162.36 / $900.00	Professional	QZ	$137.41	$162.36	$900.00
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50