Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $420.00 / $480.00	Facility		$40.00	$420.00	$480.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.00 / $444.00 / $532.00	Professional	AA	$436.00	$444.00	$532.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $238.00 / $250.00 / $316.00	Professional	QK	$238.00	$250.00	$316.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $242.00 / $242.00 / $242.00	Professional	QX	$242.00	$242.00	$242.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $924.00 / $924.00 / $1,659.00	Professional	QZ	$924.00	$924.00	$1,659.00
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $177.30 / $180.45 / $216.70	Professional	AA	$177.30	$180.45	$216.70
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $128.05 / $128.05 / $128.05	Professional	QK	$128.05	$128.05	$128.05
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $128.05 / $128.05 / $128.05	Professional	QX	$128.05	$128.05	$128.05
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $236.40 / $265.95 / $319.14	Professional	QZ	$236.40	$265.95	$319.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $42.00	Facility		$40.00	$40.00	$42.00