Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $497.51 / $1,400.00 / $2,210.00	Professional	AA	$497.51	$1,400.00	$2,210.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $763.13 / $1,179.38 / $1,595.63	Professional	QK	$763.13	$1,179.38	$1,595.63
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $750.00 / $1,050.00 / $1,669.50	Professional	QX	$750.00	$1,050.00	$1,669.50
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $720.00 / $1,430.00 / $2,080.00	Professional	AA	$720.00	$1,430.00	$2,080.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $150.44 / $150.44 / $150.44	Professional	QK	$150.44	$150.44	$150.44
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $102.20 / $370.50 / $370.50	Professional	QX	$102.20	$370.50	$370.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $630.00 / $700.00 / $1,300.00	Professional	QZ	$630.00	$700.00	$1,300.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $104.00 / $3,395.00	Facility		$35.00	$104.00	$3,395.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QK	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QX	$39.50	$39.50	$52.00
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $52.00	Facility	QY	$39.50	$39.50	$52.00