Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier AA Low / Median / High Price $4,265.80 / $4,265.80 / $4,265.80	Facility	AA	$4,265.80	$4,265.80	$4,265.80
Aetna Facility/Professional Facility Modifier QK Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	QK	$977.24	$977.24	$977.24
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	QX	$162.18	$162.18	$162.18
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $645.65 / $1,412.54 / $3,162.28	Professional	AA	$645.65	$1,412.54	$3,162.28
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $501.19 / $776.25 / $1,445.44	Professional	QZ	$501.19	$776.25	$1,445.44
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $134.90 / $218.78 / $323.59	Professional	AA	$134.90	$218.78	$323.59
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $239.88 / $467.74	Professional	QZ	$120.23	$239.88	$467.74
Aultcare Facility/Professional Professional Modifier AA Low / Median / High Price $524.81 / $524.81 / $758.58	Professional	AA	$524.81	$524.81	$758.58
Aultcare Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $588.84 / $1,000.00	Professional	QZ	$354.81	$588.84	$1,000.00