Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $436.52 / $1,174.90 / $2,238.72	Professional	AA	$436.52	$1,174.90	$2,238.72
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $398.11 / $707.95	Professional	QX	$269.15	$398.11	$707.95
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $389.05 / $1,659.59	Professional	QY	$269.15	$389.05	$1,659.59
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $72.44 / $79.43 / $269.15	Professional	QZ	$72.44	$79.43	$269.15
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $79.43 / $380.19 / $1,318.26	Professional	AA	$79.43	$380.19	$1,318.26
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	QX	$194.98	$194.98	$194.98
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $120.23 / $281.84	Professional	QZ	$120.23	$120.23	$281.84
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QK	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QX	$39.81	$39.81	$52.48
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.81 / $39.81 / $52.48	Facility	QY	$39.81	$39.81	$52.48