Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $257.04 / $346.74	Facility		$251.19	$257.04	$346.74
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $120.23 / $407.38 / $630.96	Professional	AA	$120.23	$407.38	$630.96
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $245.47 / $660.69 / $1,258.93	Professional	QX	$245.47	$660.69	$1,258.93
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $93.33 / $109.65 / $363.08	Professional	QZ	$93.33	$109.65	$363.08
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $102.33 / $123.03 / $162.18	Professional	QZ	$102.33	$123.03	$162.18
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $69.18 / $151.36 / $204.17	Professional	QX	$69.18	$151.36	$204.17
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $128.82 / $288.40 / $380.19	Professional	QZ	$128.82	$288.40	$380.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $489.78	Facility		$302.00	$302.00	$489.78
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $338.84	Facility		$257.04	$257.04	$338.84
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $120.23 / $407.38 / $1,659.59	Professional	AA	$120.23	$407.38	$1,659.59
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $93.33 / $109.65 / $380.19	Professional	QZ	$93.33	$109.65	$380.19