Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $422.33 / $422.33 / $422.33	Facility	QK	$422.33	$422.33	$422.33
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $276.64 / $276.64 / $662.20	Facility	QX	$276.64	$276.64	$662.20
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $310.69 / $869.05 / $1,367.98	Professional	AA	$310.69	$869.05	$1,367.98
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $176.62 / $525.72 / $720.37	Professional	QK	$176.62	$525.72	$720.37
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $189.39 / $567.57 / $965.61	Professional	QX	$189.39	$567.57	$965.61
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $391.61 / $503.20 / $649.64	Professional	QY	$391.61	$503.20	$649.64
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $331.20 / $412.80 / $743.68	Professional	QZ	$331.20	$412.80	$743.68
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.46 / $152.38 / $197.80	Professional	AA	$138.46	$152.38	$197.80
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $106.32 / $192.00 / $676.40	Professional	QK	$106.32	$192.00	$676.40
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $110.77 / $142.41 / $384.00	Professional	QX	$110.77	$142.41	$384.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $85.05 / $256.00 / $424.00	Professional	QY	$85.05	$256.00	$424.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $138.46 / $170.11 / $459.00	Professional	QZ	$138.46	$170.11	$459.00
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $175.00 / $292.50 / $425.90	Professional	AA	$175.00	$292.50	$425.90
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $49.45 / $87.50 / $189.05	Professional	QX	$49.45	$87.50	$189.05
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $140.00 / $200.00 / $302.50	Professional	QZ	$140.00	$200.00	$302.50