Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $440.00	Facility		$48.00	$48.00	$440.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $518.24 / $710.18 / $2,660.00	Professional	AA	$518.24	$710.18	$2,660.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $198.06 / $198.06 / $393.70	Professional	QK	$198.06	$198.06	$393.70
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $84.00 / $84.00 / $1,230.23	Professional	QX	$84.00	$84.00	$1,230.23
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $511.44 / $671.27 / $761.36	Professional	QZ	$511.44	$671.27	$761.36
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $213.29 / $316.64 / $503.62	Professional	AA	$213.29	$316.64	$503.62
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $77.48 / $106.48 / $506.00	Professional	QK	$77.48	$106.48	$506.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $117.06 / $148.43 / $506.00	Professional	QX	$117.06	$148.43	$506.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $217.69 / $325.98 / $920.00	Professional	QZ	$217.69	$325.98	$920.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $96.85 / $242.13 / $640.00	Facility		$96.85	$242.13	$640.00
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