Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $323.59 / $478.63	Facility		$93.33	$323.59	$478.63
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,288.25 / $1,380.38 / $1,659.59	Professional	AA	$1,288.25	$1,380.38	$1,659.59
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $524.81 / $691.83 / $912.01	Professional	QX	$524.81	$691.83	$912.01
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $95.50 / $309.03 / $363.08	Professional	QZ	$95.50	$309.03	$363.08
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $64.57 / $64.57 / $64.57	Professional	QX	$64.57	$64.57	$64.57
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $104.71 / $123.03 / $141.25	Professional	QZ	$104.71	$123.03	$141.25
Aultcare Facility/Professional Professional Modifier AA Low / Median / High Price $309.03 / $309.03 / $354.81	Professional	AA	$309.03	$309.03	$354.81
Aultcare Facility/Professional Professional Modifier QZ Low / Median / High Price $251.19 / $257.04 / $275.42	Professional	QZ	$251.19	$257.04	$275.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $64.57 / $177.83	Facility		$39.81	$64.57	$177.83