Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $560.00 / $560.00	Facility		$40.00	$560.00	$560.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $832.00 / $1,266.10 / $2,051.96	Professional	AA	$832.00	$1,266.10	$2,051.96
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $450.62 / $670.56 / $960.50	Professional	QK	$450.62	$670.56	$960.50
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $246.57 / $627.65 / $1,351.85	Professional	QX	$246.57	$627.65	$1,351.85
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $735.00 / $735.00 / $1,057.30	Professional	QZ	$735.00	$735.00	$1,057.30
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $180.45 / $1,170.00 / $1,430.00	Professional	AA	$180.45	$1,170.00	$1,430.00
Ambetter Facility/Professional Professional Modifier QK Low / Median / High Price $96.80 / $204.92 / $385.45	Professional	QK	$96.80	$204.92	$385.45
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $96.80 / $128.05 / $340.11	Professional	QX	$96.80	$128.05	$340.11
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $180.81 / $217.69 / $630.00	Professional	QZ	$180.81	$217.69	$630.00
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
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Lucent Health Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Lucent Health Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50