Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $283.50 / $283.50 / $283.50	Facility	QX	$283.50	$283.50	$283.50
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $113.91 / $963.20 / $1,260.00	Professional	AA	$113.91	$963.20	$1,260.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $120.24 / $656.00 / $910.00	Professional	AA	$120.24	$656.00	$910.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $490.00 / $1,287.00 / $1,300.00	Professional	QZ	$490.00	$1,287.00	$1,300.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00