Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $336.00 / $496.00	Facility		$42.00	$336.00	$496.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $722.50 / $999.60 / $1,799.20	Professional	AA	$722.50	$999.60	$1,799.20
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $172.00 / $397.38 / $578.00	Professional	QK	$172.00	$397.38	$578.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $93.19 / $393.70 / $461.90	Professional	QX	$93.19	$393.70	$461.90
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $157.61 / $157.61 / $157.61	Professional	QZ	$157.61	$157.61	$157.61
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $459.00 / $612.00 / $663.00	Professional	AA	$459.00	$612.00	$663.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $306.00 / $306.00 / $357.00	Professional	QK	$306.00	$306.00	$357.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $306.00 / $306.00 / $306.00	Professional	QX	$306.00	$306.00	$306.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $459.00 / $632.50 / $1,026.00	Professional	QZ	$459.00	$632.50	$1,026.00
Qualchoice Facility/Professional Professional Modifier AA Low / Median / High Price $527.85 / $703.80 / $762.45	Professional	AA	$527.85	$703.80	$762.45
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $527.85 / $595.13 / $1,179.90	Professional	QZ	$527.85	$595.13	$1,179.90