Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $524.81 / $954.99 / $1,949.84	Professional	AA	$524.81	$954.99	$1,949.84
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $194.98 / $660.69 / $1,122.02	Professional	QZ	$194.98	$660.69	$1,122.02
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $158.49 / $363.08 / $977.24	Professional	AA	$158.49	$363.08	$977.24
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $162.18 / $354.81 / $1,047.13	Professional	QZ	$162.18	$354.81	$1,047.13
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