Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $806.60 / $896.32 / $1,896.99	Professional	AA	$806.60	$896.32	$1,896.99
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $824.93 / $824.93 / $824.93	Professional	QX	$824.93	$824.93	$824.93
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $824.93 / $824.93 / $824.93	Professional	QY	$824.93	$824.93	$824.93
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 $800.00 / $800.00 / $800.00	Professional	AA	$800.00	$800.00	$800.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $198.28 / $220.00 / $280.50	Professional	QX	$198.28	$220.00	$280.50
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $245.90 / $245.90 / $245.90	Professional	QY	$245.90	$245.90	$245.90
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $184.68 / $301.24 / $579.30	Professional	QZ	$184.68	$301.24	$579.30
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $469.20 / $469.20 / $469.20	Professional	QZ	$469.20	$469.20	$469.20