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 / $235.59	Professional	AA	$78.51	$78.51	$235.59
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $65.02 / $65.02 / $65.02	Professional	QX	$65.02	$65.02	$65.02
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $313.31 / $313.31 / $313.31	Professional	QY	$313.31	$313.31	$313.31
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $77.94 / $77.94 / $77.94	Professional	QZ	$77.94	$77.94	$77.94
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $80.36 / $80.36 / $135.60	Professional	AA	$80.36	$80.36	$135.60
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $270.00 / $270.00 / $270.00	Professional	QX	$270.00	$270.00	$270.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $115.86 / $115.86 / $204.00	Professional	QZ	$115.86	$115.86	$204.00
Medica Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Medica Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $234.60 / $234.60 / $234.60	Professional	QZ	$234.60	$234.60	$234.60