Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.52 / $520.00 / $712.08	Facility		$357.52	$520.00	$712.08
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $499.90 / $912.18 / $2,040.00	Professional	AA	$499.90	$912.18	$2,040.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $355.40 / $468.32 / $622.99	Professional	QK	$355.40	$468.32	$622.99
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $371.74 / $449.35 / $612.75	Professional	QX	$371.74	$449.35	$612.75
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $721.81 / $790.56 / $1,070.27	Professional	QZ	$721.81	$790.56	$1,070.27
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $231.73 / $561.00 / $1,100.00	Professional	AA	$231.73	$561.00	$1,100.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $87.26 / $145.40 / $225.93	Professional	QK	$87.26	$145.40	$225.93
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $105.98 / $171.84 / $540.00	Professional	QX	$105.98	$171.84	$540.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $184.68 / $254.90 / $715.00	Professional	QZ	$184.68	$254.90	$715.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $2,615.98 / $3,041.64	Facility		$42.84	$2,615.98	$3,041.64
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $527.85 / $527.85 / $527.85	Professional	QZ	$527.85	$527.85	$527.85