Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $610.00 / $610.00	Facility		$30.00	$610.00	$610.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $410.80 / $410.80 / $413.10	Professional	AA	$410.80	$410.80	$413.10
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $195.00 / $195.00 / $195.00	Professional	QX	$195.00	$195.00	$195.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $325.00 / $325.00 / $325.00	Professional	QZ	$325.00	$325.00	$325.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,950.00 / $3,990.00	Facility		$1,200.00	$1,950.00	$3,990.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50