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 $410.80 / $410.80 / $413.10	Professional	AA	$410.80	$410.80	$413.10
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $219.30 / $514.08 / $514.08	Professional	QX	$219.30	$514.08	$514.08
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $116.34 / $116.34 / $116.34	Professional	QZ	$116.34	$116.34	$116.34
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $85.17 / $124.38 / $396.00	Professional	AA	$85.17	$124.38	$396.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $111.38 / $111.38 / $111.38	Professional	QZ	$111.38	$111.38	$111.38
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