Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $77.62 / $933.25 / $1,949.84	Professional	AA	$77.62	$933.25	$1,949.84
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $436.52 / $707.95	Professional	QX	$269.15	$436.52	$707.95
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $269.15 / $501.19 / $1,202.26	Professional	QY	$269.15	$501.19	$1,202.26
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 QX Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	QX	$52.48	$52.48	$52.48
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $81.28 / $100.00 / $102.33	Professional	QZ	$81.28	$100.00	$102.33
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $51.29 / $114.82 / $151.36	Professional	QX	$51.29	$114.82	$151.36
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $97.72 / $218.78 / $288.40	Professional	QZ	$97.72	$218.78	$288.40
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $234.42 / $851.14 / $1,949.84	Professional	AA	$234.42	$851.14	$1,949.84
Health Alliance Plan Facility/Professional Professional Modifier QX Low / Median / High Price $269.15 / $446.68 / $1,412.54	Professional	QX	$269.15	$446.68	$1,412.54
Health Alliance Plan Facility/Professional Professional Modifier QY Low / Median / High Price $389.05 / $501.19 / $1,202.26	Professional	QY	$389.05	$501.19	$1,202.26
Health Alliance Plan Facility/Professional Professional Modifier QZ Low / Median / High Price $72.44 / $79.43 / $269.15	Professional	QZ	$72.44	$79.43	$269.15