Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $252.00 / $372.00	Facility		$42.00	$252.00	$372.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $42.00 / $312.00	Professional		$35.00	$42.00	$312.00
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $153.00 / $178.50 / $178.50	Professional	QX	$153.00	$178.50	$178.50
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $131.01 / $306.00 / $412.08	Professional	QZ	$131.01	$306.00	$412.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.50 / $270.00 / $350.00	Professional		$199.50	$270.00	$350.00
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $175.95 / $175.95 / $205.28	Professional	QX	$175.95	$175.95	$205.28
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $351.90 / $351.90 / $473.89	Professional	QZ	$351.90	$351.90	$473.89
United Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $50.00 / $59.00	Professional		$38.00	$50.00	$59.00