Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $645.65 / $645.65 / $645.65	Professional	AA	$645.65	$645.65	$645.65
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $389.05 / $537.03	Professional	QX	$269.15	$389.05	$537.03
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $269.15 / $389.05	Professional	QY	$269.15	$269.15	$389.05
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $72.44 / $107.15 / $645.65	Professional	QZ	$72.44	$107.15	$645.65
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	AA	$79.43	$79.43	$79.43
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	QX	$50.12	$50.12	$50.12
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $97.72 / $257.04 / $389.05	Professional	QZ	$97.72	$257.04	$389.05
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $295.12 / $354.81 / $446.68	Professional	QZ	$295.12	$354.81	$446.68