Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $398.11 / $691.83 / $1,202.26	Professional	AA	$398.11	$691.83	$1,202.26
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $389.05 / $630.96 / $831.76	Professional	QZ	$389.05	$630.96	$831.76
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $309.03 / $676.08	Professional	AA	$138.04	$309.03	$676.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $251.19 / $691.83	Professional	QZ	$117.49	$251.19	$691.83
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90