Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $172.30 / $954.88 / $1,484.41	Professional	AA	$172.30	$954.88	$1,484.41
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $376.05 / $547.17 / $734.93	Professional	QK	$376.05	$547.17	$734.93
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $380.88 / $590.10 / $975.05	Professional	QX	$380.88	$590.10	$975.05
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $227.50 / $467.38 / $654.89	Professional	QY	$227.50	$467.38	$654.89
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $331.20 / $446.40 / $714.00	Professional	QZ	$331.20	$446.40	$714.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $140.35 / $291.18 / $950.00	Professional	AA	$140.35	$291.18	$950.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $77.44 / $96.80 / $249.41	Professional	QK	$77.44	$96.80	$249.41
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $77.44 / $104.47 / $245.00	Professional	QX	$77.44	$104.47	$245.00
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $77.44 / $96.80 / $204.06	Professional	QY	$77.44	$96.80	$204.06
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $140.35 / $273.14 / $560.00	Professional	QZ	$140.35	$273.14	$560.00
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 / $360.00	Professional	QY	$180.00	$180.00	$360.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50