Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $306.55 / $402.40	Facility		$45.00	$306.55	$402.40
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $357.50 / $529.29 / $529.29	Professional	AA	$357.50	$529.29	$529.29
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $258.00 / $258.00 / $258.00	Professional	QX	$258.00	$258.00	$258.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $381.60 / $381.60 / $381.60	Professional	QZ	$381.60	$381.60	$381.60
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $103.65 / $103.65 / $111.38	Professional	AA	$103.65	$103.65	$111.38
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $182.25 / $182.25 / $182.25	Professional	QZ	$182.25	$182.25	$182.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $275.00 / $435.00	Professional		$142.03	$275.00	$435.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00