Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $302.00 / $389.05 / $660.69	Professional	QX	$302.00	$389.05	$660.69
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $416.87 / $416.87 / $416.87	Professional	QY	$416.87	$416.87	$416.87
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	QZ	$537.03	$537.03	$537.03
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	QX	$338.84	$338.84	$338.84
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	QY	$338.84	$338.84	$338.84
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $162.18 / $602.56	Professional	QZ	$117.49	$162.18	$602.56
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