Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,080.00 / $1,080.00 / $1,080.00	Professional	AA	$1,080.00	$1,080.00	$1,080.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $429.16 / $681.29 / $1,025.99	Professional	QX	$429.16	$681.29	$1,025.99
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $531.69 / $807.29 / $884.62	Professional	QY	$531.69	$807.29	$884.62
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $854.00 / $854.00 / $1,127.00	Professional	QZ	$854.00	$854.00	$1,127.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $287.50 / $589.52 / $589.52	Professional	AA	$287.50	$589.52	$589.52
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $108.85 / $141.44 / $408.13	Professional	QX	$108.85	$141.44	$408.13
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $141.44 / $141.44 / $245.90	Professional	QY	$141.44	$141.44	$245.90
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $158.32 / $289.30 / $445.47	Professional	QZ	$158.32	$289.30	$445.47
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 / $360.00	Professional	QY	$180.00	$180.00	$360.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50