Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $616.60 / $724.44	Facility		$436.52	$616.60	$724.44
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $616.60 / $1,096.48 / $1,819.70	Professional	AA	$616.60	$1,096.48	$1,819.70
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $380.19 / $549.54 / $776.25	Professional	QK	$380.19	$549.54	$776.25
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $416.87 / $562.34 / $812.83	Professional	QX	$416.87	$562.34	$812.83
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $501.19 / $602.56 / $1,122.02	Professional	QZ	$501.19	$602.56	$1,122.02
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $199.53 / $302.00 / $870.96	Professional	AA	$199.53	$302.00	$870.96
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $89.13 / $107.15 / $275.42	Professional	QK	$89.13	$107.15	$275.42
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $97.72 / $131.83 / $177.83	Professional	QX	$97.72	$131.83	$177.83
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $302.00 / $512.86 / $758.58	Professional	QZ	$302.00	$512.86	$758.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $102.33 / $309.03	Facility		$87.10	$102.33	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10