Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $78.51 / $78.51 / $78.51	Professional	AA	$78.51	$78.51	$78.51
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $348.48 / $445.50 / $522.72	Professional	QX	$348.48	$445.50	$522.72
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $497.31 / $497.31 / $542.52	Professional	QY	$497.31	$497.31	$542.52
BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $58.74 / $114.75 / $152.55	Professional	QX	$58.74	$114.75	$152.55
BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $110.94 / $216.75 / $288.14	Professional	QZ	$110.94	$216.75	$288.14
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $120.00 / $120.00 / $509.94	Professional	QX	$120.00	$120.00	$509.94
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $120.00 / $120.00 / $509.94	Professional	QY	$120.00	$120.00	$509.94
Health Alliance Plan Facility/Professional Professional Modifier AA Low / Median / High Price $78.51 / $78.51 / $78.51	Professional	AA	$78.51	$78.51	$78.51
Health Alliance Plan Facility/Professional Professional Modifier QX Low / Median / High Price $348.48 / $445.50 / $522.72	Professional	QX	$348.48	$445.50	$522.72
Health Alliance Plan Facility/Professional Professional Modifier QY Low / Median / High Price $497.31 / $497.31 / $542.52	Professional	QY	$497.31	$497.31	$542.52