Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $407.40 / $407.40 / $407.40	Facility	QX	$407.40	$407.40	$407.40
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $806.60 / $806.60 / $1,707.72	Professional	AA	$806.60	$806.60	$1,707.72
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $584.79 / $896.51 / $896.51	Professional	QX	$584.79	$896.51	$896.51
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $907.90 / $907.90 / $907.90	Professional	QZ	$907.90	$907.90	$907.90
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $393.30 / $393.30 / $816.00	Professional	AA	$393.30	$393.30	$816.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $227.81 / $227.81 / $345.64	Professional	QX	$227.81	$227.81	$345.64
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $199.70 / $199.70 / $199.70	Professional	QY	$199.70	$199.70	$199.70
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $301.24 / $579.30 / $698.63	Professional	QZ	$301.24	$579.30	$698.63
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 / $180.00	Professional	QY	$180.00	$180.00	$180.00