Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.72 / $490.48 / $643.84	Facility		$28.72	$490.48	$643.84
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $90.44 / $90.44 / $97.60	Facility	QX	$90.44	$90.44	$97.60
Aetna Facility/Professional Facility Modifier QZ Low / Median / High Price $1,863.73 / $1,863.73 / $1,863.73	Facility	QZ	$1,863.73	$1,863.73	$1,863.73
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $684.00 / $952.50 / $2,660.00	Professional	AA	$684.00	$952.50	$2,660.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $397.50 / $614.90 / $862.88	Professional	QK	$397.50	$614.90	$862.88
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $254.44 / $730.13 / $929.25	Professional	QX	$254.44	$730.13	$929.25
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $517.83 / $607.21 / $710.18	Professional	QZ	$517.83	$607.21	$710.18
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $251.81 / $412.97 / $680.00	Professional	AA	$251.81	$412.97	$680.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $118.86 / $188.86 / $592.50	Professional	QK	$118.86	$188.86	$592.50
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $114.02 / $130.00 / $784.00	Professional	QX	$114.02	$130.00	$784.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $208.55 / $277.16 / $334.13	Professional	QZ	$208.55	$277.16	$334.13
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QK	$240.00	$240.00	$240.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $240.00 / $240.00 / $240.00	Professional	QX	$240.00	$240.00	$240.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $224.84 / $428.40 / $696.00	Professional		$224.84	$428.40	$696.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00