Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $720.00 / $976.00	Facility		$30.00	$720.00	$976.00
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $243.10 / $243.10 / $3,079.37	Facility	QX	$243.10	$243.10	$3,079.37
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,143.30 / $1,473.17 / $2,196.50	Professional	AA	$1,143.30	$1,473.17	$2,196.50
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $147.59 / $832.40 / $1,024.03	Professional	QK	$147.59	$832.40	$1,024.03
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $389.67 / $682.69 / $1,012.00	Professional	QX	$389.67	$682.69	$1,012.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $331.75 / $331.75 / $331.75	Professional	QZ	$331.75	$331.75	$331.75
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $1,110.00 / $1,110.00 / $2,220.00	Professional	AA	$1,110.00	$1,110.00	$2,220.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $202.00 / $538.20 / $663.83	Professional	QK	$202.00	$538.20	$663.83
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $242.50 / $325.00 / $637.50	Professional	QX	$242.50	$325.00	$637.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $533.50 / $776.00 / $1,420.00	Professional	QZ	$533.50	$776.00	$1,420.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,950.00 / $3,990.00	Facility		$1,200.00	$1,950.00	$3,990.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50