Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $536.45	Facility		$30.00	$30.00	$536.45
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $119.71 / $1,677.90 / $1,677.90	Professional	AA	$119.71	$1,677.90	$1,677.90
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $724.21 / $724.21 / $724.21	Professional	QX	$724.21	$724.21	$724.21
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $92.78 / $307.20 / $384.30	Professional	QZ	$92.78	$307.20	$384.30
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $106.22 / $256.00 / $320.00	Professional	QX	$106.22	$256.00	$320.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $122.88 / $255.00 / $306.00	Professional	QZ	$122.88	$255.00	$306.00
BCBS Facility/Professional Professional Modifier AA Low / Median / High Price $140.00 / $234.00 / $340.72	Professional	AA	$140.00	$234.00	$340.72
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $39.56 / $70.00 / $151.24	Professional	QX	$39.56	$70.00	$151.24
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $112.00 / $160.00 / $242.00	Professional	QZ	$112.00	$160.00	$242.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $1,950.00 / $3,000.00	Facility		$30.00	$1,950.00	$3,000.00