Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $262.50 / $346.10	Facility		$250.00	$262.50	$346.10
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 QZ Low / Median / High Price $525.00 / $525.00 / $525.00	Professional	QZ	$525.00	$525.00	$525.00
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $78.31 / $153.00 / $203.40	Professional	QX	$78.31	$153.00	$203.40
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $147.91 / $289.00 / $384.20	Professional	QZ	$147.91	$289.00	$384.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $301.35 / $494.90 / $494.90	Facility		$301.35	$494.90	$494.90
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $260.00 / $260.00 / $346.10	Facility		$260.00	$260.00	$346.10
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $410.80 / $410.80 / $413.10	Professional	AA	$410.80	$410.80	$413.10
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $525.00 / $525.00 / $525.00	Professional	QZ	$525.00	$525.00	$525.00