Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $851.14 / $977.24 / $1,548.82	Professional	AA	$851.14	$977.24	$1,548.82
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $316.23 / $457.09 / $645.65	Professional	QX	$316.23	$457.09	$645.65
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $61.66 / $562.34 / $645.65	Professional	QY	$61.66	$562.34	$645.65
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $125.89 / $389.05 / $870.96	Professional	QZ	$125.89	$389.05	$870.96
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	QX	$162.18	$162.18	$162.18
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	QY	$162.18	$162.18	$162.18
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $107.15 / $144.54 / $144.54	Professional	QZ	$107.15	$144.54	$144.54
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90