Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $741.31 / $1,380.38 / $2,290.87	Professional	AA	$741.31	$1,380.38	$2,290.87
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $407.38 / $562.34 / $776.25	Professional	QK	$407.38	$562.34	$776.25
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $389.05 / $562.34 / $776.25	Professional	QX	$389.05	$562.34	$776.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $165.96 / $1,047.13 / $1,288.25	Professional	QZ	$165.96	$1,047.13	$1,288.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $389.05 / $389.05	Professional	AA	$389.05	$389.05	$389.05
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $91.20 / $134.90 / $354.81	Professional	QK	$91.20	$134.90	$354.81
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $91.20 / $123.03 / $275.42	Professional	QX	$91.20	$123.03	$275.42
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $181.97 / $199.53 / $204.17	Professional	QZ	$181.97	$199.53	$204.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $38.90 / $52.48	Facility		$33.11	$38.90	$52.48