Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $41.69 / $371.54	Facility		$41.69	$41.69	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $446.68	Professional		$34.67	$44.67	$446.68
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $389.05 / $389.05	Professional	AA	$389.05	$389.05	$389.05
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $489.78 / $549.54	Professional	QX	$295.12	$489.78	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $295.12 / $309.03 / $489.78	Professional	QY	$295.12	$309.03	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $134.90 / $346.74	Professional	QZ	$120.23	$134.90	$346.74
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $60.26 / $60.26 / $151.36	Professional	QX	$60.26	$60.26	$151.36
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	QY	$204.17	$204.17	$204.17
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $141.25 / $354.81	Professional	QZ	$117.49	$141.25	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $269.15 / $363.08	Professional		$199.53	$269.15	$363.08
Qualchoice Facility/Professional Professional Modifier QX Low / Median / High Price $177.83 / $177.83 / $177.83	Professional	QX	$177.83	$177.83	$177.83
Qualchoice Facility/Professional Professional Modifier QY Low / Median / High Price $234.42 / $234.42 / $234.42	Professional	QY	$234.42	$234.42	$234.42
Qualchoice Facility/Professional Professional Modifier QZ Low / Median / High Price $354.81 / $407.38 / $416.87	Professional	QZ	$354.81	$407.38	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $58.88	Professional		$38.02	$50.12	$58.88