Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.25 / $440.00 / $662.00	Facility		$21.25	$440.00	$662.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $805.80 / $984.00 / $1,820.00	Professional	AA	$805.80	$984.00	$1,820.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $180.99 / $416.68 / $525.84	Professional	AA	$180.99	$416.68	$525.84
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $90.50 / $90.50 / $90.50	Professional	QK	$90.50	$90.50	$90.50
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $90.50 / $90.50 / $100.55	Professional	QX	$90.50	$90.50	$100.55
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $1,067.80 / $1,067.80 / $1,067.80	Professional	QZ	$1,067.80	$1,067.80	$1,067.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $520.00 / $821.12	Professional		$350.00	$520.00	$821.12